放射治疗和免疫治疗的精确组合治疗以联合PD-L1成像和T细胞成像为指导
Hui Yi1, Qi Luo2, Zixian Bai1
1Medical Isotopes Research Center and Department of Radiation Medicine, School of Basic Medical Sciences, International Cancer Institute, Peking University, Beijing, China.
Journal for immunotherapy of cancer
|November 19, 2025
概括
这项研究引入了SPECT/CT成像,以指导PD-1/PD-L1阻塞和放射治疗的联合治疗. T细胞成像预测预后,使精确的癌症治疗具有更高的疗效和安全性.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 医疗成像医学成像
背景情况:
- 结合PD-1/PD-L1阻塞和放射治疗 (RT) 的组合疗法显示出有前途,但受到低于最佳的剂量安排和潜在毒性的影响.
- 目前的策略缺乏最优时机的准确指导,导致效果不令人满意,并增加了治疗引起的死亡等风险.
研究的目的:
- 开发和验证精确的癌症治疗策略,使用SPECT/CT成像来指导PD-1/PD-L1阻塞与RT结合的施用时间表.
- 利用成像生物标志物来预测组合治疗的预后,从而提高疗效和安全性.
主要方法:
- 使用PD-L1准探针 (99mTc-MY1523) 进行单光子发射计算断层扫描 (SPECT) /CT成像,用于监测RT后PD-L1的动态表达.
- 使用T细胞向探针 (Tc-sum IL-2<99m) 的SPECT/CT成像用于预测组合治疗结果.
- 该方法在不同的RT疗法下在免疫"热"和"冷"瘤模型中得到了验证.
主要成果:
- 当在RT后的PD-L1上调窗口中进行抗PD-1 (αPD-1) 治疗时,可以获得最佳的抗瘤疗效,根据动态PD-L1成像检测.
- 虽然PD-L1成像表明最佳时间,但T细胞成像,专注于瘤透T细胞的变化,准确地预测了预后.
- 在确定窗口期间的αPD-1治疗后RT逆转了CD8+T细胞耗尽,并将瘤免疫微环境转向响应瘤的抗瘤状态.
结论:
- PD-L1成像有效地指导了与RT结合的αPD-1的时间.
- T细胞成像是组合疗法预后的优越预测器.
- 综合成像策略促进了个性化的精确疗法,提高了疗效和安全性,并有可能用于临床转化.
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