Boskovitz Abraham, Wikstrand Carol J, Kuan Chien-Tsun, Zalutsky Michael R, Reardon David A, Bigner Darell D
Department of Pathology, Duke University Medical Center, Durham, NC 27710, USA.
Expert Opin Biol Ther. 2004 Sep;4(9):1453-71. doi: 10.1517/14712598.4.9.1453.
Conventional treatment of brain tumours includes surgical, radiotherapeutic and chemotherapeutic modalities. Nonetheless, the outcome of patients with brain tumours, in particular glioblastoma, remains poor. Immunotherapy with armed or unarmed monoclonal antibodies targeting tumour-specific antigens has emerged in the last two decades as a novel potential adjuvant treatment for all types of neoplasia. Many challenges to its implementation as a safe and viable therapy for brain tumours still need to be addressed; nevertheless, results from ongoing Phase I/II clinical trials are encouraging, as disease stabilisation and patient survival prolongation have been observed. Advances in preclinical and clinical research indicate that treatment of brain tumours with monoclonal antibodies can be increasingly adjusted to the characteristics of the targeted tumour and its environment. This aspect relies on the careful selection of the target antigen and corresponding specific monoclonal antibody, and antibody format (size, class, affinity), conjugation to the appropriate toxin or radioactive isotope (half-life, range), and proper compartmental administration.
脑肿瘤的传统治疗方法包括手术、放射治疗和化学治疗。尽管如此,脑肿瘤患者,尤其是胶质母细胞瘤患者的治疗效果仍然很差。在过去二十年中,使用靶向肿瘤特异性抗原的武装或非武装单克隆抗体进行免疫治疗已成为一种针对所有类型肿瘤的新型潜在辅助治疗方法。将其作为脑肿瘤的安全可行治疗方法实施仍面临许多挑战,仍需解决;然而,正在进行的I/II期临床试验结果令人鼓舞,因为已观察到疾病稳定和患者生存期延长。临床前和临床研究的进展表明,用单克隆抗体治疗脑肿瘤可以越来越多地根据靶向肿瘤及其环境的特征进行调整。这方面依赖于对靶抗原和相应特异性单克隆抗体的仔细选择,以及抗体形式(大小、类别、亲和力)、与适当毒素或放射性同位素的偶联(半衰期、射程)和适当的局部给药。