前列腺癌的免疫治疗和治疗性疫苗:当前策略及临床意义的更新。

Immunotherapy and therapeutic vaccines in prostate cancer: an update on current strategies and clinical implications.

机构信息

Medical Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 10 Center Drive, Bethesda, Maryland, USA.

出版信息

Asian J Androl. 2014 May-Jun;16(3):364-71. doi: 10.4103/1008-682X.122585.

Abstract

In recent years, immunotherapy has emerged as a viable and attractive strategy for the treatment of prostate cancer. While there are multiple ways to target the immune system, therapeutic cancer vaccines and immune checkpoint inhibitors have been most successful in late-stage clinical trials. The landmark Food and Drug Administration approval of sipuleucel-T for asymptomatic or minimally symptomatic metastatic prostate cancer set the stage for ongoing phase III trials with the cancer vaccine PSA-TRICOM and the immune checkpoint inhibitor ipilimumab. A common feature of these immune-based therapies is the appearance of improved overall survival without short-term changes in disease progression. This class effect appears to be due to modulation of tumor growth rate kinetics, in which the activated immune system exerts constant immunologic pressure that slows net tumor growth. Emerging data suggest that the ideal population for clinical trials of cancer vaccines is patients with lower tumor volume and less aggressive disease. Combination strategies that combine immunotherapy with standard therapies have been shown to augment both immune response and clinical benefit.

摘要

近年来,免疫疗法已成为治疗前列腺癌的一种可行且有吸引力的策略。虽然有多种方法可以靶向免疫系统,但在晚期临床试验中,治疗性癌症疫苗和免疫检查点抑制剂最为成功。标志性的食品和药物管理局批准 sipuleucel-T 用于无症状或轻度症状转移性前列腺癌,为正在进行的 III 期临床试验奠定了基础,这些试验使用了癌症疫苗 PSA-TRICOM 和免疫检查点抑制剂 ipilimumab。这些基于免疫的疗法的一个共同特征是改善了总体生存率,而疾病进展没有短期变化。这种类效应似乎是由于肿瘤生长速度动力学的调节,其中激活的免疫系统施加持续的免疫压力,从而减缓净肿瘤生长。新出现的数据表明,癌症疫苗临床试验的理想人群是肿瘤体积较小且疾病侵袭性较小的患者。已显示联合免疫疗法与标准疗法的组合策略可增强免疫反应和临床获益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac79/4023361/3a02215c3d27/AJA-16-364-g001.jpg

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