Gupta Shalini, Kanodia Avinash K
Lady Hardinge Medical College, New Delhi, India.
Natl Med J India. 2002 Jul-Aug;15(4):202-7.
Biological response modifiers improve the body's ability to fight cancer by immunostimulation. Although a century has passed since the first attempt was made to stimulate the host immune system against cancer, only the past decade has witnessed the scientific use of biological response modifiers. Recent advances in tumour immunology have enabled the development of specific agents targeted against cancer cells. Various biological response modifiers include monoclonal antibodies, interferons, interleukins, tumour necrosis factor, colony stimulating factors and anticancer vaccines. Monoclonal antibodies directed against tumour-specific agents have been approved for the treatment of breast cancer (trastuzumab), non-Hodgkin's lymphoma (rituximab) and for the diagnosis of certain cancers (oncoscint). Interferons are indicated for the treatment of certain leukaemias and Kaposi's sarcoma to inhibit tumour proliferation and angiogenesis. Interleukin-2 is the most widely studied interleukin, and is used for immunostimulation in metastatic renal cell carcinoma and malignant melanoma. Haematopoletic growth factors are often combined with chemotherapy and radiotherapy to restore bone marrow function and treat complications such as infection and bleeding. Thalidomide, which suppresses tumour necrosis factor-alpha production and has antiangiogenic properties, is currently under evaluation in several cancers. Various anticancer vaccines are being developed using tumour cells, carbohydrates, peptides and heat-shock proteins as antigens. DNA-based vaccinations and the use of recombinant bacteria and viruses to deliver antigens or the DNA coding for them are also being investigated. However, the optimum choice of antigen, delivery vector and adjuvant, and administration regimen for some of these biological response modifiers are still being investigated.
生物反应调节剂通过免疫刺激提高机体对抗癌症的能力。尽管自首次尝试刺激宿主免疫系统对抗癌症以来已过去一个世纪，但仅在过去十年才见证了生物反应调节剂的科学应用。肿瘤免疫学的最新进展使得能够开发针对癌细胞的特异性药物。各种生物反应调节剂包括单克隆抗体、干扰素、白细胞介素、肿瘤坏死因子、集落刺激因子和抗癌疫苗。针对肿瘤特异性药物的单克隆抗体已被批准用于治疗乳腺癌（曲妥珠单抗）、非霍奇金淋巴瘤（利妥昔单抗）以及用于某些癌症的诊断（癌胚抗原显像剂）。干扰素被用于治疗某些白血病和卡波西肉瘤，以抑制肿瘤增殖和血管生成。白细胞介素-2是研究最广泛的白细胞介素，用于转移性肾细胞癌和恶性黑色素瘤的免疫刺激。造血生长因子常与化疗和放疗联合使用，以恢复骨髓功能并治疗感染和出血等并发症。沙利度胺可抑制肿瘤坏死因子-α的产生并具有抗血管生成特性，目前正在多种癌症中进行评估。正在研发各种以肿瘤细胞、碳水化合物、肽和热休克蛋白为抗原的抗癌疫苗。基于DNA的疫苗接种以及使用重组细菌和病毒来递送抗原或编码抗原的DNA也在研究中。然而，这些生物反应调节剂中某些的抗原、递送载体和佐剂的最佳选择以及给药方案仍在研究中。
