Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Adv Exp Med Biol. 2020;1258:199-221. doi: 10.1007/978-3-030-43085-6_14.
Approximately 800 people are diagnosed with osteosarcoma (OSA) per year in the USA. Although 70% of patients with localized OSA are cured with multiagent chemotherapy and surgical resection, the prognosis for patients with metastatic or relapsed disease is guarded. The small number of patients diagnosed annually contributes to an incomplete understanding of disease pathogenesis, and challenges in performing appropriately powered clinical trials and detecting correlative biomarkers of response. While mouse models of OSA are becoming increasingly sophisticated, they generally fail to accurately recapitulate tumor heterogeneity, tumor microenvironment (TME), systemic immune dysfunction, and the clinical features of tumor recurrence, metastases, and chemoresistance, which influence outcome. Pet dogs spontaneously develop OSA with an incidence that is 30-50 times higher than humans. Canine OSA parallels the human disease in its clinical presentation, biological behavior, genetic complexity, and therapeutic management. However, despite therapy, most dogs die from metastatic disease within 1 year of diagnosis. Since OSA occurs in immune-competent dogs, immune factors that sculpt tumor immunogenicity and influence responses to immune modulation are in effect. In both species, immune modulation has shown beneficial effects on patient outcome and work is now underway to identify the most effective immunotherapies, combination of immunotherapies, and correlative biomarkers that will further improve clinical response. In this chapter, the immune landscape of canine OSA and the immunotherapeutic strategies used to modulate antitumor immunity in dogs with the disease will be reviewed. From this immunological viewpoint, the value of employing dogs with spontaneous OSA to accelerate and inform the translation of immunotherapies into the human clinic will be underscored.
在美国,每年约有 800 人被诊断患有骨肉瘤(OSA)。尽管 70%的局限性 OSA 患者通过多药化疗和手术切除治愈,但转移性或复发性疾病患者的预后仍不容乐观。每年诊断出的患者数量较少,导致对疾病发病机制的了解不完整,并且在进行适当功率的临床试验和检测反应相关生物标志物方面也面临挑战。虽然 OSA 的小鼠模型变得越来越复杂,但它们通常无法准确再现肿瘤异质性、肿瘤微环境(TME)、全身免疫功能障碍以及肿瘤复发、转移和化疗耐药的临床特征,这些特征会影响预后。宠物狗会自发患上 OSA,其发病率比人类高 30-50 倍。犬 OSA 在临床表现、生物学行为、遗传复杂性和治疗管理方面与人类疾病相似。然而,尽管进行了治疗,大多数狗在诊断后 1 年内仍死于转移性疾病。由于 OSA 发生在免疫功能正常的狗中,因此会影响肿瘤免疫原性并影响对免疫调节反应的免疫因素实际上在起作用。在这两个物种中,免疫调节对患者的预后都有有益的影响,目前正在努力确定最有效的免疫疗法、免疫疗法的组合以及相关的生物标志物,这将进一步提高临床反应。在本章中,将回顾犬 OSA 的免疫景观以及用于调节患有该病的狗的抗肿瘤免疫的免疫治疗策略。从免疫学角度来看,利用患有自发性 OSA 的狗来加速和告知免疫疗法在人类临床中的转化将具有重要价值。