摘要
肝细胞癌(HCC)是全球最常见的实体肿瘤之一,也是导致癌症相关死亡的第二大原因。晚期复发性HCC通常需要全身性药物治疗,其中多种酪氨酸激酶抑制剂,索拉非尼是一线治疗的选择。但由于早期出现耐药性和与药相关不良反应的原因,它表现出非常有限的生存获益和肿瘤反应。免疫治疗方法现在被广泛研究作为一种有效的替代治疗HCC。一些免疫检查点抑制剂(ICI),如尼鲁单抗和派姆单抗,被批准作为索拉非尼耐药HCC患者的单药治疗。但是,在肿瘤微环境中存在过多的免疫抑制信号往往会导致不成功的免疫治疗。在这种情况下,组合免疫疗法作为一种通过阻断肿瘤微环境(TME)中的免疫抑制信号来改善治疗结果的方法越来越被接受。血管内皮生长因子(VEGF)抑制剂与ICI联合使用在各种临床前和临床研究中产生了显著的协同效应。然而,与当前合成的VEGF抑制剂相关的不良反应限制了其临床效用。在这篇综述中,我们总结了植物化学物质,特别是黄酮、生物碱、糖苷、萜类和香豆素作为可用的安全有效的VEGF抑制剂存储库的潜力。本文回顾了它们作为与ICI协同联合替代合成VEGF抑制剂的可能性,从而提高了患者的依从性和生存率。这篇综述强调了对植物性抗血管生成免疫治疗联合治疗HCC的合理作用的需求。
关键词: 肝细胞癌、血管内皮生长因子、植物成分、免疫治疗、中性粒细胞、细胞毒性T细胞、调节性T细胞。
图形摘要
Current Drug Targets
Title:Anti-VEGF Mediated Immunomodulatory Role of Phytochemicals: Scientific Exposition for Plausible HCC Treatment
Volume: 22 Issue: 11
关键词: 肝细胞癌、血管内皮生长因子、植物成分、免疫治疗、中性粒细胞、细胞毒性T细胞、调节性T细胞。
摘要: Hepatocellular carcinoma (HCC) is one of the most common solid tumours and the second leading cause of cancer-related mortality worldwide. Advanced-recurrent HCC often requires a systemic drug therapy where multi tyrosine kinase inhibitor, Sorafenib represents the first-line therapy option. But it exhibited very limited survival benefit and tumour response due to the early emergence of drug resistance and drug-related adverse effect. Immunotherapy approaches now being widely studied as an effective alternative treatment for HCC. Several immune checkpoint inhibitors (ICI), such as Nivolumab and Pembrolizumab, are approved as monotherapy in sorafenib-resistant HCC patients. But, the existence of a plethora of immunosuppressive signals in the tumour microenvironment often leads to unsuccessful immunotherapies. In this context, combinatorial immunotherapies are getting much acceptance as a way to improve therapeutic outcomes by blocking immunosuppressive signals in the tumour microenvironment (TME). The combination of Vascular Endothelial Growth Factor (VEGF) inhibitors with ICI resulted in significant synergistic effects in various preclinical and clinical studies. However, the adverse effects associated with current synthetic VEGF inhibitors limit its clinical utility. In this review, we have summarized the potential of phytochemicals, especially the category of flavonoids, alkaloids, glycosides, terpenoids, and coumarin, as the available-affordable-safe-effective repositories of VEGF inhibitors. Their possibilities as an alternative for synthetic VEGF inhibitors by synergistic combination with ICI are reviewed, thereby enhancing patient compliance and survival rates. This review highlights the demand for a detailed investigation of the plausible role of plant-based anti-angiogenic-immunotherapy combination against HCC.
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Cite this article as:
Anti-VEGF Mediated Immunomodulatory Role of Phytochemicals: Scientific Exposition for Plausible HCC Treatment, Current Drug Targets 2021; 22 (11) . https://dx.doi.org/10.2174/1389450122666210203194036
DOI https://dx.doi.org/10.2174/1389450122666210203194036 |
Print ISSN 1389-4501 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5592 |
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