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Combination strategies with PD-1/PD-L1 blockade: current advances and future directions

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单位: [1]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Oncol, Wuhan 430030, Peoples R China [2]Zhengzhou Univ, Affiliated Canc Hosp, Dept Radiat Oncol, Zhengzhou 450008, Peoples R China [3]Henan Canc Hosp, Zhengzhou 450008, Peoples R China
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关键词: PD-1 PD-L1 Combination therapy Angiogenesis inhibitor Radiotherapy STING Gut microbiota Bispecific antibody

摘要:
Antibodies targeting programmed cell death protein-1 (PD-1) or its ligand PD-L1 rescue T cells from exhausted status and revive immune response against cancer cells. Based on the immense success in clinical trials, ten alpha-PD-1 (nivolumab, pembrolizumab, cemiplimab, sintilimab, camrelizumab, toripalimab, tislelizumab, zimberelimab, prolgolimab, and dostarlimab) and three alpha-PD-L1 antibodies (atezolizumab, durvalumab, and avelumab) have been approved for various types of cancers. Nevertheless, the low response rate of alpha-PD-1/PD-L1 therapy remains to be resolved. For most cancer patients, PD-1/PD-L1 pathway is not the sole speed-limiting factor of antitumor immunity, and it is insufficient to motivate effective antitumor immune response by blocking PD-1/PD-L1 axis. It has been validated that some combination therapies, including alpha-PD-1/PD-L1 plus chemotherapy, radiotherapy, angiogenesis inhibitors, targeted therapy, other immune checkpoint inhibitors, agonists of the co-stimulatory molecule, stimulator of interferon genes agonists, fecal microbiota transplantation, epigenetic modulators, or metabolic modulators, have superior antitumor efficacies and higher response rates. Moreover, bifunctional or bispecific antibodies containing alpha-PD-1/PD-L1 moiety also elicited more potent antitumor activity. These combination strategies simultaneously boost multiple processes in cancer-immunity cycle, remove immunosuppressive brakes, and orchestrate an immunosupportive tumor microenvironment. In this review, we summarized the synergistic antitumor efficacies and mechanisms of alpha-PD-1/PD-L1 in combination with other therapies. Moreover, we focused on the advances of alpha-PD-1/PD-L1-based immunomodulatory strategies in clinical studies. Given the heterogeneity across patients and cancer types, individualized combination selection could improve the effects of alpha-PD-1/PD-L1-based immunomodulatory strategies and relieve treatment resistance.

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出版当年[2021]版:
大类 | 1 区 医学
小类 | 1 区 生化与分子生物学 1 区 肿瘤学
最新[2025]版:
大类 | 1 区 医学
小类 | 1 区 生化与分子生物学 1 区 肿瘤学
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出版当年[2020]版:
Q1 ONCOLOGY Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY
最新[2023]版:
Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY Q1 ONCOLOGY

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第一作者单位: [1]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Oncol, Wuhan 430030, Peoples R China
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通讯机构: [1]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Oncol, Wuhan 430030, Peoples R China [2]Zhengzhou Univ, Affiliated Canc Hosp, Dept Radiat Oncol, Zhengzhou 450008, Peoples R China [3]Henan Canc Hosp, Zhengzhou 450008, Peoples R China
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