朱贵东, 傅阳心. 设计新一代抗体药物偶联物J. 药学学报, 2013,48(7): 1053-1070.
引用本文: 朱贵东, 傅阳心. 设计新一代抗体药物偶联物J. 药学学报, 2013,48(7): 1053-1070.
ZHU Gui-dong, FU Yang-xin. Design of next generation antibody drug conjugatesJ. 药学学报, 2013,48(7): 1053-1070.
Citation: ZHU Gui-dong, FU Yang-xin. Design of next generation antibody drug conjugatesJ. 药学学报, 2013,48(7): 1053-1070.

设计新一代抗体药物偶联物

Design of next generation antibody drug conjugates

  • 摘要:

    化疗依然是包括手术、放疗、以及靶向疗法在内的最重要的抗癌手段之一。尽管高效细胞毒素很多, 但癌细胞和健康细胞之间微小的差别限制了这些抗癌化合物因为毒副作用在临床上的广泛应用。鉴于抗肿瘤单克隆抗体对肿瘤细胞表面抗原的特异性, 抗体药物已经成为肿瘤治疗的标准疗法, 但单独使用时疗效经常不尽人意。抗体药物偶联物 (antibody drug conjugate, ADC) 克隆抗体和高效细胞毒素完美地结合到一起, 充分利用了前者靶向、选择性强, 后者活性高, 同时又消除了前者疗效偏低和后者副作用偏大等缺陷。其中抗体是ADC的制导系统, 能够靶向性地把效应分子输送到肿瘤细胞, 有效地提高了抗体本身对癌细胞的杀伤力。ADC包括抗体、接头 (linker) 和细胞毒素 (也经常称为效应分子) 三个组成部分。通过靶向特定抗原, ADC有效地渗透到肿瘤组织, 并被肿瘤细胞吞噬进入酶溶体, 释放效应分子。尽管ADC新药的开发已经获得前所未有的成功, 技术上仍然有待进一步优化, 其中包括被肿瘤细胞吞噬的效率、细胞毒素的活性以及效应分子的释放等。本文简单介绍ADC领域的研究进展, 并试图从抗体、接头和效应分子三个方面, 讨论提高ADC分子在循环系统的稳定性等一系列优化ADC分子特征的策略。对当前ADC领域技术上存在的问题, 以及中国公司进入这个领域要面临的挑战进行深度分析, 并提出一些积极的应对方案。

     

    Abstract:

    Chemtherapy remains one of the major tools, along with surgery, radiotherapy, and more recently targeted therapy, in the war against cancer.  There have appeared a plethora of highly potent cytotoxic drugs but the poor discriminability between cancerous and healthy cells of these agents limits their broader application in clinical settings.  Therapeutic antibodies have emerged as an important class of biological anticancer agents, thanks to their ability in specific binding to tumor-associated antigens.  While this important class of biologics can be used as single agents for the treatment of cancer through antibody-dependent cell cytotoxicity (ADCC), their therapeutical efficacy is often limited.  Antitumor antibody drug conjugates (ADCs) combine the target- specificity of monoclonal antibody (mAb) and the highly active cell-killing drugs, taking advantages of the best characteristics out of both components.  Thus, insufficiency of most naked mAbs in cancer therapy has been circumvented by arming the immunoglobulin with cytotoxic drugs.  Here mAbs are used as vehicles to transport potent payloads to tumor cells.  ADCs contain three main components: antibody, linker and cytotoxics (also frequently referred as payload).  Antibodies can recognize and specifically bind to the tumor-specific antigens, leading to an antibody-assisted internalization, and payload release.  While ADC has demonstrated tremendous success, a number of practical challenges limit the broader applications of this new class of anticancer therapy, including inefficient cellular uptake, low cytotoxicity, and off-target effects.  This review article aims to cover recent advances in optimizing linkers with increased stability in circulation while allowing efficient payload release within tumor cells.  We also attempt to provide some practical strategies in resolving the current challenges in this attractive research area, particularly to those new to the field.

     

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