代谢重编程——克服血液肿瘤耐药性的潜在治疗靶点

Metabolic reprogramming:a potential therapeutic target to overcome drug resistance in hematologic tumors

血液肿瘤是指起源于造血系统的恶性肿瘤,主要包括白血病、多发性骨髓瘤和恶性淋巴瘤等。目前,血液肿瘤的治疗主要以放化疗结合靶向药物为主。虽然在治疗初期患者病情可以得到一定程度的改善,但在进一步治疗过程中,肿瘤细胞对化疗或靶向治疗的抵抗是导致治疗失败和疾病复发的主要原因。诸多研究表明,代谢重编程参与血液肿瘤的进展、耐药与肿瘤免疫,肿瘤细胞通过代谢调节以产生足够的能量供应并逃避抗肿瘤免疫监视。因此,深入研究肿瘤代谢重编程与多药耐药之间的相关性,对于逆转肿瘤耐药、阻止肿瘤复发具有重要意义。本文主要就血液肿瘤代谢重编程在治疗耐受中的研究进展及针对代谢重编程的肿瘤靶向治疗作一综述。

Hematologic tumors are malignant tumors originating from the hematopoietic system,mainly including leukemia,multiple myeloma and malignant lymphoma.At present,the treatment of hematological tumors is mainly based on chemoradiotherapy combined with targeted drugs.Although the condition of patients can be improved to a certain extent at the initial stage of treatment,the resistance of tumor cells to chemotherapy or targeted therapy is the main cause of treatment failure and disease recurrence in the course of further treatment.Numerous studies have shown that metabolic reprogramming is involved in hematological tumor progression,drug resistance and tumor immunity,and tumor cells are metabolically regulated in order to generate sufficient energy supply and evade anti-tumor immune surveillance.Therefore,in-depth study of the correlation between tumor metabolic reprogramming and multidrug resistance is of great significance for reversing tumor drug resistance and preventing tumor recurrence.This review mainly summarizes the progress of metabolic reprogramming in hematological tumors in treatment tolerance and tumor-targeted therapies targeting metabolic reprogramming.