Gunturi Anasuya, McDermott David F
Beth Israel Deaconess Medical Center, MASCO 428, 375 Longwood Ave, Boston, MA, 02215, USA.
Curr Treat Options Oncol. 2014 Mar;15(1):137-46. doi: 10.1007/s11864-013-0268-y.
Various targeted immunotherapies have shown efficacy in metastatic renal cell carcinoma (RCC) recently. Specifically, molecules targeting the PD-1/PD-L1 pathway have shown promising results. These agents appear to provide several advantages over previous standard therapies. First, higher objective responses are attained with these agents, many of which are complete and durable. Second, these drugs are associated with less overall treatment-related toxicity. This allows for the testing of various combination therapies that may provide better clinical outcomes. Finally, these novel therapeutics are unique in that they appear to have benefit in a variety of neoplasms, including those with dismal prognosis such as metastatic non-small cell lung cancer (NSCLC). Further investigations are needed to confirm these findings and explore additional applications. The importance of PD-L1 expression on tumor cells on the efficacy of PD-1 and PD-L1 inhibitors is also under investigation. Patient selection based on this expression may optimize the observed clinical benefit. Thus, we believe that new therapeutics such as Anti-PD1 and Anti-PD-L1 antibodies will make a significant impact on cancer treatment in general as well as in the field of kidney cancer.
近年来，多种靶向免疫疗法在转移性肾细胞癌（RCC）中显示出疗效。具体而言，靶向PD-1/PD-L1通路的分子已显示出有前景的结果。这些药物似乎比先前的标准疗法具有多个优势。首先，使用这些药物可获得更高的客观缓解率，其中许多缓解是完全且持久的。其次，这些药物总体上与治疗相关毒性较小。这使得可以测试各种联合疗法，可能会带来更好的临床结果。最后，这些新型疗法的独特之处在于，它们似乎对多种肿瘤有益，包括那些预后不佳的肿瘤，如转移性非小细胞肺癌（NSCLC）。需要进一步研究来证实这些发现并探索更多应用。肿瘤细胞上PD-L1表达对PD-1和PD-L1抑制剂疗效的重要性也在研究中。基于这种表达进行患者选择可能会优化观察到的临床获益。因此，我们认为诸如抗PD1和抗PD-L1抗体等新型疗法将对总体癌症治疗以及肾癌领域产生重大影响。
