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Research Progress on Combination Therapies Based on PD-1/PD-L1 Blockade Against Malignancies and the Adjuvant Effects
Juntao Wang1,2, Shunchao Zhang3, Yuhan Wei4
1Department of Oncology, Ward 2, The Third Affiliated Hospital of Henan, University of Chinese Medicine, Zhengzhou 450008, Henan, China.
Abstract:
Programmed death (PD-1) is an important immune checkpoint receptor expressed on the surface of T cells, B cells and natural killer (NK) cells. PD-L1 (B7-H1) is a critical ligand for PD-1, and is widely expressed in a variety of cancer cells, immune cells, and normal histocytes. It has been established that the PD-1/PD-L1 interaction can produce an immunosuppressive effect by suppressing T cell proliferation, cytokine secretion, and cytotoxicity. Currently, PD-1 and PD-L1 inhibitors are known to be promising anticancer agents that reverse the antitumor immune function of T cells by inhibiting the PD-1/PD-L1 axis. The monotherapy of PD-1/PD-L1 blockade, while effective in treating cancers, is limited by a low response rate, immune-related adverse events (irAEs), and drug resistance. Their combinations with surgery, chemotherapy, radiotherapy, immunotherapy, hormone therapy, and traditional Chinese medicine (TCM), due to a synergistic effect, have broadened the frontier of cancer research. Following a holistic principle, TCM serves as an adjuvant therapy with PD-1/PD-L1 blockade, and provides benefits through complicated mechanisms. We specifically focused on the profound significance of TCM's assistance of PD-1/PD-L1 blockade, and the opportunities and challenges of treating cancers with both TCM and PD-1/PD-L1 blockade.
Insights
Programmed death (PD-1) and its ligand PD-L1 are key in cancer immunity. Combining PD-1/PD-L1 blockade with Traditional Chinese Medicine (TCM) shows promise for improved cancer treatment outcomes.
Area of Science:
- Immunology
- Oncology
- Pharmacology
Background:
- Programmed death (PD-1) is an immune checkpoint receptor on immune cells, interacting with PD-L1 ligand found on cancer cells.
- The PD-1/PD-L1 interaction suppresses anti-tumor immune responses by inhibiting T cell functions.
- PD-1/PD-L1 inhibitors are effective anticancer agents but face limitations like low response rates and resistance.
Purpose of the Study:
- To explore the role of Traditional Chinese Medicine (TCM) as an adjuvant therapy in combination with PD-1/PD-L1 blockade for cancer treatment.
- To analyze the synergistic effects and complex mechanisms of TCM in enhancing PD-1/PD-L1 blockade efficacy.
- To identify opportunities and challenges in utilizing combined TCM and PD-1/PD-L1 blockade strategies for cancer therapy.
Main Methods:
- Review of current literature on PD-1/PD-L1 blockade in cancer therapy.
- Analysis of studies investigating the combination of PD-1/PD-L1 inhibitors with various cancer treatments, including TCM.
- Exploration of the holistic principles and mechanisms of TCM as an adjuvant therapy.
Main Results:
- Combination therapies, including with TCM, broaden cancer treatment options beyond monotherapy.
- TCM demonstrates potential synergistic effects when used alongside PD-1/PD-L1 blockade.
- The integration of TCM offers a holistic approach to potentially overcome limitations of PD-1/PD-L1 blockade.
Conclusions:
- Combining PD-1/PD-L1 blockade with TCM presents a promising avenue for improving cancer treatment efficacy.
- Further research is needed to fully elucidate the mechanisms and optimize the application of TCM in conjunction with PD-1/PD-L1 inhibitors.
- Addressing challenges and leveraging opportunities in combined therapies can advance cancer care.
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