Multidisciplinary Oncology and Therapeutic Innovations Department, Aix Marseille University - Assistance Publique Hôpitaux de Marseille; Aix Marseille University - Inserm U911, Marseille, France.
Ther Adv Med Oncol. 2012 Mar;4(2):43-50. doi: 10.1177/1758834011431718.
Ipilimumab is a fully human monoclonal antibody that enhances antitumor immunity by way of cytotoxic T-lymphocyte antigen 4 blockade. It has already been approved by the US Food and Drug Administration for the treatment of metastatic melanoma and is being investigated for treating other solid tumors such as renal cell, prostate and lung cancers. This review details the potential of ipilimumab in the management of non-small cell lung cancer (NSCLC). In particular, ipilimumab showed promising results in a first-line NSCLC phase II study combining carboplatin/paclitaxel chemotherapy with concurrent or phased ipilimumab. The median immune-related progression-free survival was 5.68 months for the phased ipilimumab arm versus 4.63 months for chemotherapy alone (hazard ratio [HR] = 0.68, p = 0.026) and 5.52 months for the concurrent ipilimumab arm versus 4.63 months for chemotherapy alone (HR = 0.77, p = 0.094). The main adverse events were immune related, such as hypophysitis, enterocolitis, and hyperthyroidism. These adverse events may be improved with high-dose glucocorticoids and may be correlated with tumor response. Phase III studies are ongoing. Future studies may investigate ipilimumab in the management of early stage lung cancer. Strategies for potential translational research studies are also discussed to identify prognostic and predictive biomarkers for the use of ipilimumab in the treatment of patients with NSCLC.
依匹单抗是一种完全人源化的单克隆抗体，通过细胞毒性 T 淋巴细胞相关抗原 4 阻断增强抗肿瘤免疫。它已被美国食品和药物管理局批准用于治疗转移性黑色素瘤，并正在研究用于治疗其他实体瘤，如肾细胞癌、前列腺癌和肺癌。这篇综述详细介绍了依匹单抗在非小细胞肺癌（NSCLC）治疗中的潜力。特别是，依匹单抗在联合卡铂/紫杉醇化疗与序贯或同期依匹单抗治疗一线 NSCLC 的 II 期研究中显示出了良好的疗效。同期依匹单抗组的中位免疫相关无进展生存期为 5.68 个月，而化疗组为 4.63 个月（HR=0.68，p=0.026）；序贯依匹单抗组为 5.52 个月，而化疗组为 4.63 个月（HR=0.77，p=0.094）。主要的不良反应是免疫相关的，如垂体炎、肠炎和甲状腺功能亢进。这些不良反应可能随着高剂量糖皮质激素的使用而改善，并且可能与肿瘤反应相关。III 期研究正在进行中。未来的研究可能会探讨依匹单抗在早期肺癌中的应用。还讨论了潜在的转化研究策略，以确定在治疗 NSCLC 患者时使用依匹单抗的预后和预测生物标志物。
