Traditional Chinese medicine inhibits PD-1/PD-L1 axis to sensitize cancer immunotherapy: a literature review

Huilan Zheng; Gang Wang; Ming Liu; Hongbin Cheng

doi:10.3389/fonc.2023.1168226

Traditional Chinese medicine inhibits PD-1/PD-L1 axis to sensitize cancer immunotherapy: a literature review

Front Oncol. 2023 Jun 16:13:1168226. doi: 10.3389/fonc.2023.1168226. eCollection 2023.

Authors

Huilan Zheng¹, Gang Wang², Ming Liu³, Hongbin Cheng¹

Affiliations

¹ Department of Dermatology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
² National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, Sichuan, China.
³ Department of Medical Oncology/Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

Abstract

The Programmed death-1 (PD-1) and its programmed death-ligand 1 (PD-L1) comprise the PD-1/PD-L1 axis and maintain tumor immune evasion. Cancer immunotherapy based on anti-PD-1/PD-L1 antibodies is the most promising anti-tumor treatment available but is currently facing the thorny problem of unsatisfactory outcomes. Traditional Chinese Medicine (TCM), with its rich heritage of Chinese medicine monomers, herbal formulas, and physical therapies like acupuncture, moxibustion, and catgut implantation, is a multi-component and multi-target system of medicine known for enhancing immunity and preventing the spread of disease. TCM is often used as an adjuvant therapy for cancer in clinical practices, and recent studies have demonstrated the synergistic effects of combining TCM with cancer immunotherapy. In this review, we examined the PD-1/PD-L1 axis and its role in tumor immune escape while exploring how TCM therapies can modulate the PD-1/PD-L1 axis to improve the efficacy of cancer immunotherapy. Our findings suggest that TCM therapy can enhance cancer immunotherapy by reducing the expression of PD-1 and PD-L1, regulating T-cell function, improving the tumor immune microenvironment, and regulating intestinal flora. We hope this review may serve as a valuable resource for future studies on the sensitization of immune checkpoint inhibitors (ICIs) therapy.

Keywords: PD-1/PD-L1 axis; cancer immunotherapy; immune checkpoint inhibitor; sensitization; traditional Chinese medicine.

Publication types

Review

Grants and funding

This work was supported by grants from the “Hundred Talents Project” of the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine (Grant No. P2020042), a randomized controlled clinical study of Sanhuang Zengmian Decoction in treating mild to moderate SLE, no. 2021ZD03, and a clinical study on treating simple obesity with combined catgut embedding combined with traditional Chinese medicine, no. 2021MS035.