St. Francis Hospital and Medical Center, Department of Hematology-Oncology, Medical Oncology and Blood Disorders, Gothic Park, 43 Woodland Street, Suite G-80, Hartford, CT 06105, USA.
Expert Opin Biol Ther. 2012 Jul;12(7):923-37. doi: 10.1517/14712598.2012.685715. Epub 2012 May 5.
Subjects with lung cancer were shown to present a variety of immune abnormalities including cellular immune dysfunction, cytokine alterations, and antigen presentation defects. As discouraging results are commonly seen with the existing therapies in lung cancer, more innovative treatment strategies are needed.
The authors review comprehensively the immune abnormalities in individuals with lung cancer, describe the lung cancer immunotherapy candidates that are most advanced in their clinical development, and summarize recent data from clinical trials of these agents.
Enhancing the immune system represents an appealing avenue for lung cancer therapy. Several immunomodulating agents have activity in this regard including ipilimumab, a monoclonal antibody against the CTLA-4, and talactoferrin, a dendritic cell activator. In addition, a significant activity was shown with belagenpumatucel-L, a whole-cell-based vaccine that blocks the action of TGF-β2. Other promising vaccines are protein-specific vaccines against tumor antigens such as MAGE-A3, EGF, and MUC1. Although some of these immunotherapies may have lackluster performance as single agents in advanced disease, more impressive results are seen in combination with chemotherapy agents. Given their proven activity in lung cancer, these immunotherapies may soon become a powerful addition to the oncologist's toolbox.
患有肺癌的患者表现出多种免疫异常，包括细胞免疫功能障碍、细胞因子改变和抗原呈递缺陷。由于现有的肺癌治疗方法通常效果不佳，因此需要更具创新性的治疗策略。
作者全面回顾了肺癌患者的免疫异常，描述了在临床开发中最先进的肺癌免疫治疗候选药物，并总结了这些药物的临床试验的最新数据。
增强免疫系统是肺癌治疗的一个有吸引力的途径。几种免疫调节剂具有这种作用，包括针对 CTLA-4 的单克隆抗体 ipilimumab 和树突细胞激活剂 talactoferrin。此外，还显示了 belagenpumatucel-L（一种阻断 TGF-β2 作用的全细胞疫苗）具有显著的活性。其他有前途的疫苗是针对肿瘤抗原（如 MAGE-A3、EGF 和 MUC1）的蛋白特异性疫苗。尽管这些免疫疗法中的一些作为单一药物在晚期疾病中的表现可能不佳，但与化疗药物联合使用时会产生更显著的效果。鉴于它们在肺癌中的已证实活性，这些免疫疗法可能很快成为肿瘤学家工具包的有力补充。
