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检查点阻断作为癌症治疗的发展:现状如何,未来如何?

The evolution of checkpoint blockade as a cancer therapy: what's here, what's next?

机构信息

Department of Medicine, Division of Hematology-Oncology, University of California Los Angeles (UCLA), Los Angeles, CA, USA; Department of Molecular, Cellular and Integrative Physiology, UCLA, Los Angeles, CA, USA.

Department of Medicine, Division of Hematology-Oncology, University of California Los Angeles (UCLA), Los Angeles, CA, USA; Department of Molecular and Medical Pharmacology, UCLA, Los Angeles, CA, USA; Department of Surgery, Division of Surgical-Oncology, UCLA, Los Angeles, CA, USA; Jonsson Comprehensive Cancer Center at UCLA, 10833 Le Conte Avenue, Los Angeles, CA 90095-1782, USA; Department of Molecular, Cellular and Integrative Physiology, UCLA, Los Angeles, CA, USA.

出版信息

Curr Opin Immunol. 2015 Apr;33:23-35. doi: 10.1016/j.coi.2015.01.006. Epub 2015 Jan 23.


DOI:10.1016/j.coi.2015.01.006
PMID:25621841
Abstract

Unleashing the immune system to fight cancer has become one of the main treatment modalities since the anti-CTLA-4 antibody, ipilimumab was approved for patients with advanced melanoma in 2011. Pembrolizumab and nivolumab, two anti-PD-1 antibodies recently approved for the treatment of patients with metastatic melanoma, are being actively investigated for the treatment of multiple caners including lung, breast, bladder and renal cancers along with other anti-PD-1/L1 antibodies. Early results of combining of anti-CTLA-4 antibody and anti-PD-1 antibody treatment for advanced melanoma patients are showing impressive response rates with manageable toxicity profiles. There are several other checkpoint molecules that are likely potential inhibitory targets. The outcome of blocking some of these negative immune regulators, such as LAG-3 or TIM-3, is being pursued in the clinic or about to enter clinical development. Blockade of these molecules is demonstrating promising preclinical activity alone or when combined with anti-PD-1/L1. Future studies will define bio-markers of these therapies and how to target them alone or in combination with other immunotherapies, chemotherapy, radiotherapy and small molecule inhibitors.

摘要

自 2011 年抗 CTLA-4 抗体伊匹单抗被批准用于晚期黑色素瘤患者以来,激发免疫系统对抗癌症已成为主要治疗方式之一。最近批准用于治疗转移性黑色素瘤患者的两种抗 PD-1 抗体——派姆单抗和纳武单抗,正在积极研究用于治疗多种癌症,包括肺癌、乳腺癌、膀胱癌和肾癌,以及其他抗 PD-1/L1 抗体。联合使用抗 CTLA-4 抗体和抗 PD-1 抗体治疗晚期黑色素瘤患者的早期结果显示,其具有令人印象深刻的缓解率和可管理的毒性特征。还有其他几个检查点分子可能是潜在的抑制性靶点。阻断这些负性免疫调节剂(如 LAG-3 或 TIM-3)中的一些的效果正在临床试验中或即将进入临床开发阶段。这些分子的阻断单独或与抗 PD-1/L1 联合使用均显示出有前景的临床前活性。未来的研究将确定这些疗法的生物标志物,以及如何单独或联合其他免疫疗法、化疗、放疗和小分子抑制剂来靶向这些疗法。

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