新辅助剂Fc增强的抗CTLA-4向Tregs增强高风险前列腺癌的雄激素缺乏:一个随机的第一阶段试验
Casey R Ager1, Aleksandar Obradovic2, Patrick McCann3
1Department of Medicine, Division of Hematology and Oncology, Columbia University Irving Medical Center, New York, NY 10032, USA; Columbia Center for Translational Immunology, Columbia University Irving Medical Center, New York, NY 10032, USA; Department of Immunology, Mayo Clinic Arizona, Phoenix, AZ 85054, USA; Department of Urology, Mayo Clinic Arizona, Phoenix, AZ 85054, USA.
Cell reports. Medicine
|February 27, 2026
概括
新辅助性抗雄激素剥夺疗法加上一种阿福可赛化抗CTLA-4抗体是高风险前列腺癌 (PCa) 的安全和可行的. 这种组合疗法减少了瘤透调节性T细胞 (TI-Tregs),增强了抗瘤免疫反应.
科学领域:
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
- 临床试验 临床试验
背景情况:
- 高危局部性前列腺癌 (PCa) 具有显著的术后复发率.
- 目前的新辅助疗法不是PCa的标准,因为有效性有限.
- 瘤透调节性T细胞 (TI-Tregs) 阻碍了抗雄激素剥夺治疗 (ADT) 的有效性.
研究的目的:
- 评估新辅助剂afucosylated anti-CTLA-4抗体 (BMS-986218) 结合ADT在患有高风险PCa的男性中的安全性和可行性.
- 评估这种联合治疗对TI-Treg频率的影响.
- 探索与治疗相关的免疫机制和临床结果.
主要方法:
- 一个单中心,双臂,开放标签的临床试验.
- 24名患有高风险局部PCa的男性被随机分配到接受BMS-986218或没有BMS-986218的ADT,然后进行激进前列腺切除术.
- 机理学研究分析了TI-Tregs,树突细胞 (DC) 和T细胞反应的变化.
主要成果:
- 新辅助组合疗法耐受性良好,并且可行.
- 用BMS-986218治疗导致TI-Treg频率降低.
- 减少TI-Tregs与Fc受体 (FCGR3A) 在巨细胞的表达相关,DC调制,并增强T细胞原始化.
- 更大的Treg抑制和增加的DC频率与改善的临床结果有关.
结论:
- 新辅助剂ADT加Fc增强的抗CTLA-4抗体是高风险PCa的可行和生物活性方法.
- 这一策略在克服TI-Tregs介导的免疫抑制方面表现有前途.
- 需要进一步的研究来证实这种新的新辅助疗法的临床益处.
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