Nano-Chemotherapy synergize with immune checkpoint inhibitor- A better option?

Abstract

Immune checkpoint inhibitor (ICI) is one of the most important tumor treatment methods. Although the therapeutic efficiency of immune checkpoint inhibitor mono-therapy is limited, the combination of chemotherapy plus immune checkpoint inhibitors has shown great advantages in cancer treatment. This is mainly due to the fact that tumor reactive T cells could fully provide their anti-tumor function as chemotherapy could not only cause immunogenic cell death to increase antigen presentation, but also improve the immunosuppressive tumor micro-environment to synergize with immune checkpoint inhibitors. However, traditional chemotherapy still has shortcomings such as insufficient drug concentration in tumor region, short drug duration, drug resistance, major adverse events, etc, which might lead to the failure of the therapy. Nano chemotherapeutic drugs, which refer to chemotherapeutic drugs loaded in nano-based drug delivery system, could overcome the above shortcomings of traditional chemotherapeutic drugs to further improve the therapeutic effect of immune checkpoint inhibitors on tumors. Therefore, the scheme of nano chemotherapeutic drugs combined with immune checkpoint inhibitors might lead to improved outcome of cancer patients compared with the scheme of traditional chemotherapy combined with immune checkpoint inhibitors.

Intratumoral Injection of Large Surface Area Microparticle Taxanes in Carcinomas Increases Immune Effector Cell Concentrations, Checkpoint Expression, and Synergy with Checkpoint Inhibitors: A Review of Preclinical and Clinical Studies

“…However, clinical results from trials evaluating systemic combinations of chemotherapy and immunotherapy have often been disappointing [ 34 , 61 , 88 , 89 ]. Reduced synergism with systemic therapies may be due, in part, to depletion of lymphocytes from IV chemotherapy-related bone marrow suppression [ 90 ]. Failed immune responses aid in the selection of cancer cell clones that are less likely to undergo immune-mediated destruction [ 91 ].…”

The role of nanotherapy in head and neck squamous cell carcinoma by targeting tumor microenvironment

“…Nanotherapeutic systems can be custom designed to exhibit specificity for unique TME characteristics, such as low pH, hypoxia, tumor-associated macrophages (TAMs), and increased matrix metalloproteinases (MMPs) expression ( 126 – 128 ). Additionally, nanoparticles with loading capabilities for specific drugs and targets ( 129 , 130 ) can serve as drug carriers for chemotherapy drugs, cytotoxic agents, and immune checkpoint inhibitors ( 131 , 132 ). Such nano drug delivery systems offer superior TME targeting, protect the efficacy of loaded agents from premature degradation, and increase the drug concentration at the TME site.…”

Nanodrugs systems for therapy and diagnosis of esophageal cancer

“…Lastly, for patients with advanced esophageal squamous cell carcinoma, the recommended first-line treatment is to combine camrelizumab with paclitaxel and platinum-based chemotherapy. Even though immune checkpoint inhibitor (ICI) is one of the most important tumor treatment methods, the application of nanodrugs in the immunotherapy of esophageal cancer is still limited, and immune nano-drugs delivery system can improve the therapeutic effect of immune checkpoint inhibitors on tumors ( Qian et al, 2022 ). So, a large number of clinical trials are still necessary to verify the role of nanodrugs in the immunotherapy of esophageal cancer.…”