Department of Medicine, Arizona Cancer Center, University of Arizona, Tucson, AZ, USA.
Clin Med Insights Oncol. 2012;6:275-86. doi: 10.4137/CMO.S7245. Epub 2012 Jul 30.
Immune augmentation with ipilimumab, an anti-CTLA-4 monoclonal antibody, has joined the ranks of approved immunologic agents for the treatment of metastatic melanoma. Phase III studies of ipilimumab in metastatic melanoma have demonstrated an overall survival advantage as compared to other approved and investigational therapies. However, the adverse effects associated with this medication are unique and often require management with steroids or other immunosuppressants. In addition, the time to response differs with ipilimumab as compared to traditional chemotherapy, and alternative means of assessment of response have been proposed. In this review, we will summarize the basic science of this treatment, its preclinical evaluation, and the clinical trials leading to its approval. We will also discuss the details regarding its use, assessment of response to this drug and other immune-related therapies, and further directions for investigation.
免疫增强剂伊匹单抗(一种抗 CTLA-4 单克隆抗体)已成为治疗转移性黑色素瘤的获批免疫治疗药物之一。转移性黑色素瘤的伊匹单抗 III 期研究显示,与其他已获批和正在研究的治疗方法相比,该药具有总体生存优势。然而,与这种药物相关的不良反应是独特的,通常需要用类固醇或其他免疫抑制剂来治疗。此外,与传统化疗相比,伊匹单抗的起效时间不同,因此提出了替代的反应评估方法。在这篇综述中,我们将总结这种治疗方法的基础科学、临床前评估以及导致其获批的临床试验。我们还将讨论关于该药使用、对这种药物和其他免疫相关治疗的反应评估的细节,以及进一步的研究方向。