The use of immune checkpoint therapies targeting programmed death-1 (PD-1) and its ligand (PD-L1) continue to show limited durable success in clinical cases despite widespread application. While some patients achieve complete responses and disease remission, others are completely resistant to the therapy. Recent evidence in the field suggests that tumor-derived exosomes could be responsible for mediating systemic immunosuppression that antagonizes anti-PD-1 checkpoint therapy. In this Opinion article, we discuss our claim that endogenous tumor exosomal PD-L1 and tumor-derived exosome-induced PD-L1 are two of the most notable mechanisms of exosome-mediated resistance against antitumor immunity and we discuss how this resistance could directly influence immune checkpoint therapy failure.

尽管应用广泛，但针对程序性死亡1（PD-1）及其配体（PD-L1）的免疫检查点疗法的使用仍显示有限的持久成功。虽然有些患者可以完全缓解并缓解疾病，但其他患者则对治疗完全耐药。该领域的最新证据表明，肿瘤来源的外泌体可能负责介导与抗PD-1检查点疗法拮抗的全身性免疫抑制。在这篇观点文章中，我们讨论了我们的主张，即内源性肿瘤外泌体PD-L1和肿瘤来源的外泌体诱导的PD-L1是外泌体介导的抗肿瘤免疫抗性的两个最显着机制，并且我们讨论了这种抗性如何直接影响免疫检查点治疗失败。