Department of Immuno-Oncology, Beckman Research Institute, City of Hope Comprehensive Cancer Centre, Duarte, CA, USA.
Department of Radiation Oncology, The University of Texas Southwestern Medical Centre, Dallas, TX, USA.
Nat Rev Cancer. 2019 Oct;19(10):568-586. doi: 10.1038/s41568-019-0183-z. Epub 2019 Aug 28.
Cancer immunotherapies targeting adaptive immune checkpoints have substantially improved patient outcomes across multiple metastatic and treatment-refractory cancer types. However, emerging studies have demonstrated that innate immune checkpoints, which interfere with the detection and clearance of malignant cells through phagocytosis and suppress innate immune sensing, also have a key role in tumour-mediated immune escape and might, therefore, be potential targets for cancer immunotherapy. Indeed, preclinical studies and early clinical data have established the promise of targeting phagocytosis checkpoints, such as the CD47-signal-regulatory protein α (SIRPα) axis, either alone or in combination with other cancer therapies. In this Review, we highlight the current understanding of how cancer cells evade the immune system by disrupting phagocytic clearance and the effect of phagocytosis checkpoint blockade on induction of antitumour immune responses. Given the role of innate immune cells in priming adaptive immune responses, an improved understanding of the tumour-intrinsic processes that inhibit essential immune surveillance processes, such as phagocytosis and innate immune sensing, could pave the way for the development of highly effective combination immunotherapy strategies that modulate both innate and adaptive antitumour immune responses.
癌症免疫疗法针对适应性免疫检查点,在多种转移性和治疗耐药性癌症类型中显著改善了患者的预后。然而,新出现的研究表明,先天免疫检查点通过吞噬作用干扰对恶性细胞的检测和清除,并抑制先天免疫感应,在肿瘤介导的免疫逃逸中也起着关键作用,因此可能成为癌症免疫治疗的潜在靶点。事实上,临床前研究和早期临床数据已经证实了靶向吞噬作用检查点的潜力,例如 CD47-信号调节蛋白 α(SIRPα)轴,单独或与其他癌症疗法联合使用。在这篇综述中,我们强调了目前对癌细胞通过破坏吞噬清除来逃避免疫系统以及吞噬作用检查点阻断对诱导抗肿瘤免疫反应的影响的理解。鉴于先天免疫细胞在启动适应性免疫反应中的作用,对抑制吞噬作用和先天免疫感应等基本免疫监视过程的肿瘤内在过程的深入了解,可能为开发高度有效的组合免疫治疗策略铺平道路,这些策略可以调节先天和适应性抗肿瘤免疫反应。