前列腺癌的临床导向免疫异质性:新兴的目标和策略
MingWei Zhan1, BinBin Zhao1, Junjie Wu2,3
1Department of Urology, Hangzhou TCM Hospital of Zhejiang Chinese Medical University (Hangzhou Hospital of Traditional Chinese Medicine), Hangzhou, China.
Frontiers in immunology
|March 2, 2026
概括
前列腺癌 (PCa) 是一个免疫学上复杂的疾病. 了解免疫异质性和微环境因素是开发高级PCa有效免疫疗法的关键,包括转移性割耐药PCa (mCRPC).
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 癌症生物学 癌症生物学
背景情况:
- 前列腺癌 (PCa) 通常被认为是免疫学上"冷",限制了免疫检查点抑制剂 (ICI) 的有效性.
- 免疫检查点抑制剂 (ICI) 在未经选择的患者中显示出有限的益处,特别是那些患有转移性抵抗割的PCa (mCRPC) 或与治疗相关的神经内分泌PCa (NEPC) 的患者.
研究的目的:
- 用先进的分析技术揭示前列腺癌 (PCa) 中的免疫异质性.
- 了解免疫微环境在PCa进展和治疗耐药性的作用.
- 根据免疫分析,为PCa提供新的免疫疗法策略.
主要方法:
- 主要和转移性PCa病变的单细胞和空间分析.
- 对免疫细胞种群,空间组织和分子信号通路的分析.
- 基因组数据与微环境分层的整合.
主要成果:
- 前列腺瘤表现出显著的免疫异质性,具有明显的免疫排除,骨髓抑制和淋巴细胞丰富的区域,包括三级淋巴细胞结构 (TLS).
- 骨转移的特征是抑制性髓状细胞和功能障碍的T细胞,通常由CCL2-CCR6轴介导.
- 疗法可以通过骨髓驱动的重新连接,IL-8/CXCR2信号和疗法诱导的衰老来诱导适应性抵抗.
- 免疫规避机制包括HLAI类损失和缺氧"冷区".
结论:
- 免疫异质性是PCa免疫治疗反应的关键因素.
- 针对特定的免疫微环境和髓驱动的抵抗机制是必不可少的.
- 综合生物标志物和微环境数据的异质性意识框架可以指导个性化免疫治疗策略,以获得PCa中持久的反应.
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