Bispecific antibodies

双特异性抗体
  • 文章类型: Journal Article
    小细胞肺癌(SCLC)占所有肺癌诊断的约10%至15%,并且由于其高死亡率而代表了紧迫的全球公共卫生挑战。常规治疗SCLC的疗效欠佳,以有限的抗肿瘤作用和频繁复发为特征。在这种情况下,新兴的研究转向免疫疗法与化疗相结合,这是一个快速发展的领域,在改善SCLC患者的临床结局方面显示出希望。通过最初开发用于非小细胞肺癌(NSCLC),这些疗法拓展了SCLC的新治疗途径.目前,一系列新兴热点治疗方法已显示出显著的治疗效果.基于化疗和免疫治疗的融合,以及新的免疫治疗剂的开发,SCLC的治疗已经看到了希望的未来。通过伴随使用化疗,在增强肿瘤免疫微环境方面取得了进展。免疫疗法,和酪氨酸激酶抑制剂(TKI),正如新兴的临床试验数据所证明的那样。此外,涉及免疫疗法的三方方法,靶向治疗,化疗对未来的临床应用来说似乎是吉祥的。克服对免疫治疗后方案的耐药性仍然是一个紧迫的探索领域。最后,双特异性抗体,过继细胞转移(ACT),溶瘤病毒,单一疗法,包括Delta样配体3(DLL3)和具有Ig和ITIM结构域的T细胞免疫受体(TIGIT),以及精准医学,可能是在SCLC中实现治愈结果的前瞻性途径。这篇综述旨在综合现有文献,并强调SCLC治疗的未来方向,承认该领域的持续挑战。此外,新的治疗药物和技术的不断发展使得SCLC治疗的未来越来越乐观.
    Small cell lung cancer (SCLC) constitutes approximately 10% to 15% of all lung cancer diagnoses and represents a pressing global public health challenge due to its high mortality rates. The efficacy of conventional treatments for SCLC is suboptimal, characterized by limited anti-tumoral effects and frequent relapses. In this context, emerging research has pivoted towards immunotherapy combined with chemotherapy, a rapidly advancing field that has shown promise in ameliorating the clinical outcomes of SCLC patients. Through originally developed for non-small cell lung cancer (NSCLC), these therapies have extended new treatment avenues for SCLC. Currently, a nexus of emerging hot-spot treatments has demonstrated significant therapeutic efficacy. Based on the amalgamation of chemotherapy and immunotherapy, and the development of new immunotherapy agents, the treatment of SCLC has seen the hoping future. Progress has been achieved in enhancing the tumor immune microenvironment through the concomitant use of chemotherapy, immunotherapy, and tyrosine kinase inhibitors (TKI), as evinced by emerging clinical trial data. Moreover, a tripartite approach involving immunotherapy, targeted therapy, and chemotherapy appears auspicious for future clinical applications. Overcoming resistance to post-immunotherapy regimens remains an urgent area of exploration. Finally, bispecific antibodies, adoptive cell transfer (ACT), oncolytic virus, monotherapy, including Delta-like ligand 3 (DLL3) and T cell immunoreceptor with Ig and ITIM domains (TIGIT), as well as precision medicine, may present a prospective route towards achieving curative outcomes in SCLC. This review aims to synthesize extant literature and highlight future directions in SCLC treatment, acknowledging the persistent challenges in the field. Furthermore, the continual development of novel therapeutic agents and technologies renders the future of SCLC treatment increasingly optimistic.
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  • 文章类型: Journal Article
    近年来,在发现用于治疗中枢神经系统(CNS)疾病的治疗性蛋白质和肽方面取得了快速进展。然而,它们的临床应用受到诸如低生物膜渗透性等挑战的极大阻碍,稳定性差,循环时间短,和强大的血脑屏障(BBB)。最近,在了解BBB的动力学和开发将蛋白质和肽递送到CNS的有效方法方面已经取得了实质性的进步。特别是通过使用各种纳米粒子。在这里,我们概述了在生理和病理条件下对BBB的最新认识,强调它们对大脑药物输送的影响。我们总结了先进的策略,并阐明了将蛋白质和肽输送到大脑的潜在机制。我们重点介绍了纳米载体在通过BBB杂交治疗CNS疾病中的发展和应用。我们还对当前策略的局限性和障碍提出了批评意见,并对未来的研究提出了展望。
    Recent years have witnessed rapid progress in the discovery of therapeutic proteins and peptides for the treatment of central nervous system (CNS) diseases. However, their clinical applications have been considerably hindered by challenges such as low biomembrane permeability, poor stability, short circulation time, and the formidable blood-brain barrier (BBB). Recently, substantial improvements have been made in understanding the dynamics of the BBB and developing efficient approaches for delivering proteins and peptides to the CNS, especially by using various nanoparticles. Herein, we present an overview of the up-to-date understanding of the BBB under physiological and pathological conditions, emphasizing their effects on brain drug delivery. We summarize advanced strategies and elucidate the underlying mechanisms for delivering proteins and peptides to the brain. We highlight the developments and applications of nanocarriers in treating CNS diseases via BBB crossing. We also provide critical opinions on the limitations and obstacles of the current strategies and put forward prospects for future research.
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  • 文章类型: Journal Article
    越来越多的证据表明,放疗可能会增强免疫治疗的疗效。本研究旨在评估靶向PD-L1和CTLA-4的双特异性抗体KN046联合化疗和姑息性放疗治疗晚期食管鳞状细胞癌(ESCC)的可能性。在这个开放标签中,Ib期试验,晚期ESCC患者接受化疗和姑息性放疗,和KN046,预定义的递增剂量为1、3或5mg/kg(在化疗周期中每3周一次,在KN046维持期间每2周一次)。化疗方案包括顺铂(75mg/m2,d1)和紫杉醇(135-175mg/m2ivgtt。,d1).放射治疗细节,包括网站,定时,剂量,和碎片模式,由调查员自行决定。主要结果是剂量限制性毒性(DLT)。从2019年5月到2021年4月,在剂量组中招募了25名患者:1mg/kg中的3名,3mg/kg中的12,和10在5mg/kg。在剂量递增期间未观察到DLT。客观缓解率为41.7%(95CI22.1-63.4),而疾病控制率为87.5%(95CI67.6~97.3)。中位随访时间为11.8个月,中位无进展生存期为7.8个月(95CI5.2~9.7),中位总生存期为15.9个月(95CI8.4-NE).48.0%的患者报告了严重不良事件,主要是白细胞减少症(16%),免疫介导性小肠结肠炎(12%),免疫介导的肺炎(8%),和中性粒细胞减少(8%)。KN046联合化疗和姑息性放疗可能是可行的,在晚期ESCC患者中显示出良好的安全性和显着的疗效。
    There is growing evidence to suggest that radiotherapy might enhance the efficacy of immunotherapy. This study aimed to assess the possibility of KN046, a bispecific antibody targeting PD-L1 and CTLA-4, combined with chemotherapy and palliative radiotherapy for advanced esophageal squamous cell carcinoma (ESCC). In this open-label, phase Ib trial, patients with advanced ESCC were administered chemotherapy with palliative radiotherapy, and KN046 in the predefined escalation dosages of 1, 3, or 5 mg/kg (every 3 weeks during chemotherapy cycles and every 2 weeks during KN046 maintenance). The chemotherapy regimen constituted cisplatin (75 mg/m2 i.v., d1) and paclitaxel (135-175 mg/m2 ivgtt., d1). Radiotherapy specifics, including site, timing, dose, and fragmentation pattern, were at the investigator\'s discretion. The primary outcome was dose-limiting toxicity (DLT). From May 2019 to April 2021, 25 patients were enrolled across the dosage groups: 3 in 1 mg/kg, 12 in 3 mg/kg, and 10 in 5 mg/kg. No DLT was observed during the dose escalation. The objective response rate was 41.7% (95%CI 22.1-63.4), while the disease control rate was 87.5% (95%CI 67.6-97.3). At a median follow-up of 11.8 months, the median progression-free survival was 7.8 months (95%CI 5.2-9.7) and median overall survival was 15.9 months (95%CI 8.4-NE). Serious adverse events were reported in 48.0% of patients, predominantly leukopenia (16%), immune-mediated enterocolitis (12%), immune-mediated pneumonitis (8%), and neutropenia (8%). Combining KN046 with chemotherapy and palliative radiotherapy might be feasible, showing a favorable safety profile and notable efficacy in advanced ESCC patients.
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  • 文章类型: Journal Article
    最近,双特异性抗体(BsAb)正在发展癌症治疗的前景,并显着改善了复发性或难治性癌症患者的预后。随着越来越多的BsAb进入临床实践,特定的毒性已经出现,和肾脏副作用已被描述。然而,缺乏系统分析抗癌BsAb受体肾毒性的研究。在这次审查中,我们展示了病因,机制,BsAbs受者肾损伤的其他危险因素和治疗选择,以更全面地了解BsAbs治疗后的肾毒性。重要的是,由于每个受试者的临床试验数据有限,我们主要总结了相关的病因,机制,和发生在T细胞参与BsAb受体中的肾毒性的危险因素。与非T细胞BsAb相关的肾毒性可能与相关单克隆抗体对两种特定抗原的不良肾毒性有关。本文的目的是为肾病学家和肿瘤学家提供理论知识,为接受BsAb的接受者提供更好的医疗管理,特别是T细胞接合BsAbs治疗。
    Recently, bispecific antibodies (BsAbs) are evolving the landscape of cancer treatment and have significantly improved the outcomes of relapsed or refractory cancer patients. As increasing BsAbs entered clinical practice, specific toxicities have emerged, and renal side-effects have been described. However, there are a lack of studies analyzing the nephrotoxicity in the anti-cancer BsAbs recipients systematically. In this review, we demonstrate the etiologies, mechanisms, other risk factors and treatment options of kidney injury in the BsAbs recipients to provide a more comprehensive insight into the nephrotoxicity post-BsAbs therapy. Significantly, due to the limited clinical trial data on each subject, we mainly conclude the related etiologies, mechanisms, and risk factors of nephrotoxicity that occur in T-cell-engaging BsAbs recipients. Nephrotoxicity associated with non-T-cell BsAbs may be associated with adverse nephrotoxicity of related monoclonal antibodies to two specific antigens. The aim of this paper is to provide nephrologists and oncologists with theoretical knowledge to provide better medical management for recipients who receive BsAbs, especially T-cell-engaging BsAbs treatment.
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  • 文章类型: Journal Article
    开发了一种基于成像毛细管等电聚焦(icIEF)的方法,并将其验证为双特异性抗体(BsAb)的多属性方法。首先,作为ICIEF方法的传统应用,它用作BsAb的身份测定和纯度测定。第二,该方法也可用作BsAb组装过程中产生的同二聚体单克隆抗体的杂质测定。BsAb的同二聚体杂质分析通常通过工业中的疏水相互作用色谱法进行。当使用UV荧光检测时,icIEF方法具有良好的灵敏度(定量极限低至4µg/mL),检测蛋白质的天然荧光。这是首次报道icIEF方法已用作杂质测定。
    An imaged capillary isoelectric focusing (icIEF)-based method was developed and validated as a multi-attribute method for a bispecific antibody (BsAb). First, as the traditional application of the icIEF method, it serves as an identity assay and purity assay for the BsAb. Second, the method can also be used as an impurity assay for the homodimer monoclonal antibodies generated during BsAb assembly. The homodimer impurity analysis for BsAb is usually done by hydrophobic interaction chromatography methods in the industry. The icIEF method has good sensitivity (down to 4 µg/mL in a limit of quantitation) when UV fluorescence detection is used, which detects the native fluorescence of proteins. This is the first report that an icIEF method has been applied as impurity assay.
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  • 文章类型: Journal Article
    摘要SARS-CoV-2已经演变成大量的变种,包括高致病性Delta变异体,以及目前流行的具有广泛规避能力的Omicron亚变体,这就迫切需要开发新的广谱中和抗体。在这里,我们设计了两种IgG-(scFv)2形成具有重叠表位(bsAb1)或非重叠表位(bsAb2)的双特异性抗体。两种bsAb在针对所有测试的循环SARS-CoV-2变体(包括目前的显性JN.1)的抗原结合和病毒中和活性方面均明显优于亲本单克隆抗体。bsAb1可以有效地中和对亲本单克隆抗体或混合物不敏感的所有变体,IC50低于20ng/mL,甚至比bsAb2略好。此外,与Omicron刺突蛋白复合的bsAb1的cryo-EM结构表明,具有重叠表位的bsAb1有效地锁定了S蛋白,这说明了其对Omicron变体的保守中和作用。从重叠表位工程化的双特异性抗体策略为处理病毒免疫逃避提供了新的解决方案。
    SARS-CoV-2 has been evolving into a large number of variants, including the highly pathogenic Delta variant, and the currently prevalent Omicron subvariants with extensive evasion capability, which raises an urgent need to develop new broad-spectrum neutralizing antibodies. Herein, we engineer two IgG-(scFv)2 form bispecific antibodies with overlapping epitopes (bsAb1) or non-overlapping epitopes (bsAb2). Both bsAbs are significantly superior to the parental monoclonal antibodies in terms of their antigen-binding and virus-neutralizing activities against all tested circulating SARS-CoV-2 variants including currently dominant JN.1. The bsAb1 can efficiently neutralize all variants insensitive to parental monoclonal antibodies or the cocktail with IC50 lower than 20 ng/mL, even slightly better than bsAb2. Furthermore, the cryo-EM structures of bsAb1 in complex with the Omicron spike protein revealed that bsAb1 with overlapping epitopes effectively locked the S protein, which accounts for its conserved neutralization against Omicron variants. The bispecific antibody strategy engineered from overlapping epitopes provides a novel solution for dealing with viral immune evasion.
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  • 文章类型: Journal Article
    随着免疫疗法的出现,多发性骨髓瘤(MM)的治疗方案发生了重大变化。专注于肿瘤抗原的新疗法现在推动了MM研究的进展。双特异性抗体(bsAbs)利用生物工程技术的革命性进步,体现了第二代基于抗体的肿瘤治疗。最近对复发/难治性MM病例中bsAb的研究显示了显着的疗效和可接受的安全性。elranatamab和techlistamab的批准代表了用于治疗MM的bsAbs开发的下一步。本文综述了抗原靶向,功效,安全,以及在抗治疗性MM中应用bsAb的策略,专注于临床试验和现实世界的数据。
    The treatment options for multiple myeloma (MM) have undergone significant transformation with the advent of immunotherapy. Novel therapies that focus on tumor antigens now drive advances in MM research. Bispecific antibodies (bsAbs) leverage revolutionary advances in bioengineering techniques and embody the second generation of antibody-based tumor therapy. Recent studies on bsAbs in relapsed/refractory MM cases have revealed remarkable efficacy and acceptable safety profiles. The approval of elranatamab and teclistamab represents the next step in the development of bsAbs for the treatment of MM. This review article addresses the antigen targeting, efficacy, safety, and strategies in the application of bsAbs against treatment-resistant MM, with a focus on clinical trials and real-world data.
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  • 文章类型: Systematic Review
    尽管有大量关于宫颈癌治疗策略的文献,专门针对晚期免疫疗法的文献计量分析,经常性,或转移性(A/R/M)宫颈恶性肿瘤仍未发现。本研究旨在通过提供包括一般特征在内的全面概述来解决这一差距,研究重点,进化的轨迹,以及这个研究不足的领域目前的新兴趋势。
    使用WebofScienceCoreCollection(WOSCC)进行了系统搜索,以识别2000年至2022年之间发表的与A/R/M宫颈癌相关的文章。Citespace和VOS查看器是用于确定研究重点的主要工具,有趣的未来模式,并评估作者之间的贡献和共同事件,机构,国家,和期刊。
    共识别出1,001篇原创文章,涉及来自66个国家和1,474个机构的6,387位作者,并在366种学术期刊上发表。美国贡献最大。最有成效的研究人员是莱顿大学医学中心的VanderBurgSH。《国际癌症和癌症研究杂志》被确定为最具生产力和影响力的期刊,分别。共引聚类分析突出显示了25个聚类,主要关注潜在的预测性生物标志物,基于树突状细胞的肿瘤疫苗,治疗性HPV疫苗接种,基于肽的癌症疫苗,肿瘤免疫微环境,过继细胞转移(ACT)。A/R/M宫颈癌免疫治疗研究的最新重要趋势包括ACT,CAR-T,和免疫检查点抑制剂(ICIs),如关键字和参考突发检测所示。
    这项开创性研究提供了A/R/M宫颈癌免疫治疗研究的详细前景。它强调了全球合作的重要性,丰富了我们对A/R/M宫颈癌免疫学的认识,扩大免疫疗法的潜在受益者,并探索各种疗法的临床应用,包括治疗性疫苗,过继细胞转移,ICIs,特别是与既定的治疗如化疗相结合,放射治疗,和靶向治疗。
    UNASSIGNED: Despite extensive literature on therapeutic strategies for cervical cancer, a bibliometric analysis specifically focused on immunotherapy for advanced, recurrent, or metastatic (A/R/M) cervical malignancies remains unexplored. This study aims to address this gap by presenting a comprehensive overview that includes general characteristics, research focal points, the trajectory of evolution, and current emerging trends in this under-researched area.
    UNASSIGNED: A systematic search was conducted using the Web of Science Core Collection (WOSCC) to identify articles related to A/R/M cervical cancer published between 2000 and 2022. Citespace and VOS viewer were the primary tools used to identify research focal points, intriguing future patterns, and to evaluate contributions and co-occurrences among authors, institutions, countries, and journals.
    UNASSIGNED: A total of 1,001 original articles were identified, involving 6,387 authors from 66 countries and 1,474 institutions, and published across 366 academic journals. The United States contributed most significantly. The most productive researcher was Van der Burg SH from Leiden University Medical Center. The International Journal of Cancer and Cancer Research were identified as the most productive and influential journals, respectively. Analysis of co-citation clusters highlighted 25 clusters, primarily focusing on potential predictive biomarkers, dendritic cell-based tumor vaccines, therapeutic HPV vaccinations, peptide-based cancer vaccines, tumor immune microenvironments, and adoptive cell transfer (ACT). The latest significant trends in A/R/M cervical cancer immunotherapy research included ACT, CAR-T, and immune checkpoint inhibitors (ICIs), as revealed by keyword and reference burst detection.
    UNASSIGNED: This pioneering study provides a detailed landscape of immunotherapy research in A/R/M cervical cancer. It underscores the importance of global collaboration, enriches our understanding of the immunology of A/R/M cervical cancer, expands on potential beneficiaries of immunotherapy, and explores clinical applications of various therapies, including therapeutic vaccines, adoptive cell transfer, and ICIs, particularly in combination with established treatments such as chemotherapy, radiotherapy, and targeted therapy.
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  • 文章类型: Journal Article
    在第65届美国血液学会(ASH)2023年年会上,强调了CD20×CD3BsAb治疗B细胞淋巴瘤(BCL)的最新进展,特别是在复发/难治性(R/R)滤泡性淋巴瘤(FL)和R/R弥漫性大B细胞淋巴瘤(DLBCL)中。
    本摘要重点介绍了CD20×CD3BsAb治疗BCL的一些主要研究。
    CD20×CD3是研究最广泛的BsAb,在R/RDLBCL和R/RFL≥两行全身治疗的患者中取得了有希望的结果。一线B细胞淋巴瘤的试验也显示了有希望的结果。希望,BsAb单一疗法或含BsAb的方案可能成为FL和DLBCL患者的标准疗法。
    UNASSIGNED: At the 65th American Society of Hematology (ASH) 2023 Annual Meeting, the latest advancements in CD20×CD3 BsAbs for B-cell lymphoma (BCL) were highlighted, particularly in relapsed/refractory (R/R) follicular lymphoma (FL) and R/R diffuse large B-cell lymphoma (DLBCL).
    UNASSIGNED: This summary highlights some of the major studies on CD20×CD3 BsAbs for BCL.
    UNASSIGNED: CD20×CD3 is the most widely studied BsAb, with promising results in patients with R/R DLBCL and R/R FL ≥ two prior lines of systemic therapy. Trials with the first line of B-cell lymphoma also revealed promising results. Hopefully, BsAb monotherapy or BsAb-containing regimens may become the standard therapy in patients with FL and DLBCL.
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  • 文章类型: Journal Article
    新兴的肿瘤免疫治疗方法包括双特异性抗体(BSAB),免疫检查点抑制剂(ICIs),和过继细胞免疫疗法。BSAB属于能够特异性识别两种不同抗原或同一抗原上的表位的抗体家族。这些抗体显示优于单克隆抗体的临床疗效,表明它们作为一种有前途的肿瘤免疫治疗选择的作用。免疫检查点在肿瘤免疫治疗中也很重要。程序性细胞死亡蛋白-1(PD-1)是广泛认可的具有有效抗肿瘤活性的免疫检查点靶标。PD-1抑制剂在治疗血液肿瘤和实体瘤方面表现出显著的治疗效果;然而,超过50%的接受这种治疗的患者表现出较差的反应.然而,已经证明基于ICI的组合疗法(ICI组合疗法)协同地增加抗肿瘤作用和免疫应答率。在这次审查中,我们比较了BSABs和ICI联合疗法在现实世界肿瘤免疫治疗中的临床疗效和副作用,旨在为临床研究和个性化肿瘤诊断和治疗提供循证方法。
    Emerging tumor immunotherapy methods encompass bispecific antibodies (BSABs), immune checkpoint inhibitors (ICIs), and adoptive cell immunotherapy. BSABs belong to the antibody family that can specifically recognize two different antigens or epitopes on the same antigen. These antibodies demonstrate superior clinical efficacy than monoclonal antibodies, indicating their role as a promising tumor immunotherapy option. Immune checkpoints are also important in tumor immunotherapy. Programmed cell death protein-1 (PD-1) is a widely acknowledged immune checkpoint target with effective anti-tumor activity. PD-1 inhibitors have demonstrated notable therapeutic efficacy in treating hematological and solid tumors; however, more than 50% of patients undergoing this treatment exhibit a poor response. However, ICI-based combination therapies (ICI combination therapies) have been demonstrated to synergistically increase anti-tumor effects and immune response rates. In this review, we compare the clinical efficacy and side effects of BSABs and ICI combination therapies in real-world tumor immunotherapy, aiming to provide evidence-based approaches for clinical research and personalized tumor diagnosis and treatment.
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