[Research progress on TCM intervention in cancer based on PD-1/PD-L1 signaling pathway]

Area of Science:

• Immunology
• Oncology
• Pharmacology

Background:

• The PD-1/PD-L1 pathway is crucial for tumor immune evasion, suppressing anti-tumor immunity via T-cell exhaustion, Treg expansion, M2 macrophage polarization, NK cell dysfunction, and metabolic disruption.
• Immune checkpoint inhibitors (ICIs) targeting PD-1/PD-L1 show efficacy in solid tumors but face limitations due to resistance, irAEs, and TME heterogeneity, affecting 60-70% of patients.
• Single-target blockade is insufficient, necessitating multidimensional interventions to overcome immune escape.

Purpose of the Study:

• To systematically review the research progress on TCM active ingredients, compounds, and patent medicines in cancer immunotherapy, focusing on the PD-1/PD-L1 pathway.
• To analyze the immunoregulatory networks of TCM in modulating the PD-1/PD-L1 pathway.
• To provide theoretical insights and translational directions for optimizing cancer immunotherapy strategies using TCM.

Main Methods:

• Literature review focusing on studies investigating TCM active ingredients, compounds, and patent medicines.
• Analysis of mechanisms by which TCM regulates the PD-1/PD-L1 pathway and enhances anti-tumor immunity.
• Examination of TCM's role in modulating signaling pathways, epigenetic changes, cellular metabolism, and the tumor microenvironment.

Main Results:

• TCM active ingredients and compounds demonstrate the ability to regulate the PD-1/PD-L1 pathway through multiple targets.
• TCM interventions modulate key signaling pathways, mediate epigenetic changes, reprogram cellular metabolism, and reshape the immunosuppressive tumor microenvironment.
• These multi-target actions of TCM enhance anti-tumor immune responses.

Conclusions:

• TCM offers a promising avenue for cancer immunotherapy by targeting the PD-1/PD-L1 pathway via multi-dimensional mechanisms.
• TCM-based strategies have the potential to overcome ICI resistance and improve therapeutic efficacy.
• Further research into TCM's immunoregulatory networks can provide valuable insights for developing novel cancer treatment strategies.