Postow Michael A, Callahan Margaret K, Wolchok Jedd D
All authors: Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY.
J Clin Oncol. 2015 Jun 10;33(17):1974-82. doi: 10.1200/JCO.2014.59.4358. Epub 2015 Jan 20.
Immunologic checkpoint blockade with antibodies that target cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) and the programmed cell death protein 1 pathway (PD-1/PD-L1) have demonstrated promise in a variety of malignancies. Ipilimumab (CTLA-4) and pembrolizumab (PD-1) are approved by the US Food and Drug Administration for the treatment of advanced melanoma, and additional regulatory approvals are expected across the oncologic spectrum for a variety of other agents that target these pathways. Treatment with both CTLA-4 and PD-1/PD-L1 blockade is associated with a unique pattern of adverse events called immune-related adverse events, and occasionally, unusual kinetics of tumor response are seen. Combination approaches involving CTLA-4 and PD-1/PD-L1 blockade are being investigated to determine whether they enhance the efficacy of either approach alone. Principles learned during the development of CTLA-4 and PD-1/PD-L1 approaches will likely be used as new immunologic checkpoint blocking antibodies begin clinical investigation.
使用靶向细胞毒性T淋巴细胞相关抗原4(CTLA-4)和程序性细胞死亡蛋白1通路(PD-1/PD-L1)的抗体进行免疫检查点阻断,已在多种恶性肿瘤中显示出前景。伊匹单抗(CTLA-4)和帕博利珠单抗(PD-1)已获美国食品药品监督管理局批准用于治疗晚期黑色素瘤,预计针对这些通路的多种其他药物在整个肿瘤学领域也将获得更多监管批准。同时使用CTLA-4和PD-1/PD-L1阻断治疗会出现一种独特的不良事件模式,称为免疫相关不良事件,偶尔还会出现不寻常的肿瘤反应动力学。目前正在研究涉及CTLA-4和PD-1/PD-L1阻断的联合治疗方法,以确定它们是否能增强单独使用任一方法的疗效。随着新型免疫检查点阻断抗体开始临床研究,在CTLA-4和PD-1/PD-L1治疗方法研发过程中所学到的原则可能会被应用。
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