间歇性PI3Kδ抑制维持抗瘤免疫力并抑制irAEs
Simon Eschweiler1, Ciro Ramírez-Suástegui1, Yingcong Li1,2
1La Jolla Institute for Immunology, La Jolla, CA, USA.
Nature
|May 4, 2022
概括
通过减少调节性T细胞和增强抗瘤免疫力,酸3-激酶δ (PI3Kδ) 抑制剂在头癌中表现有前途. 然而,毒性限制了目前的剂量,表明需要替代方案.
科学领域:
- 免疫学
- 癌症学
- 药理学
背景情况:
- 酸3-酶 (PI3Kδ) 在淋巴细胞功能中起着至关重要的作用,并被批准用于B细胞恶性瘤的抑制剂.
- 在临床前模型中,PI3Kδ抑制剂在固体瘤中具有诱导抗瘤免疫力的潜力.
- 对于人类固体瘤的PI3Kδi的疗效和作用在很大程度上尚不清楚.
研究的目的:
- 评估PI3Kδ抑制剂AMG319对人类头癌的影响.
- 评估PI3Kδ抑制对抗瘤免疫和与免疫相关的不良事件的影响.
- 在临床前模型中探索PI3Kδi引起的毒性背后的机制.
主要方法:
- 在头癌患者中对AMG319进行新辅助,双盲,随机的II期临床试验.
- 分析瘤透的淋巴细胞,包括调节性T细胞和细胞毒性T细胞.
- 在小鼠模型中进行单细胞RNA测序,以研究PI3Kδi诱导的免疫变化和毒性.
主要成果:
- 在人类患者中,PI3Kδ抑制降低了透瘤的T细胞和增强了细胞毒性T细胞的潜力.
- 在很大一部分患者中,与免疫相关的不良事件 (irAEs) 的高发病率导致治疗中止.
- 在小鼠模型中,PI3Kδi导致全身Treg降低,结肠炎和致病性T辅助细胞17 (TH17) 和CD8+T细胞 (TC17) 的扩张.
结论:
- 在人类头癌中,PI3Kδ抑制显示出免疫调节作用,但在测试剂量时与显著的毒性有关.
- 这种毒性似乎与对Treg细胞的系统性影响和致病性T细胞子集的扩张有关.
- 在临床前模型中修改间歇性剂量方案表明了减轻毒性和提高抗瘤功效的潜在策略.
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