Jezeršek Novaković Barbara
Division of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Eur J Haematol. 2016 Apr;96(4):335-43. doi: 10.1111/ejh.12697. Epub 2015 Dec 11.
Hodgkin's lymphoma is unusual among cancers in that it consists of a small number of malignant Hodgkin/Reed-Sternberg cells in a sea of immune system cells, including T cells. Most of these T cells are reversibly inactivated in different ways and their reactivation may induce a very strong immune response to cancer cells. One way of reactivation of T cells is with antibodies blocking the CTLA-4 and especially with antibodies directed against PD-1 or the PD-L1 ligand thereby reversing the tumor-induced downregulation of T-cell function and augmenting antitumor immune activity at the priming (CTLA-4) or tissue effector (PD-1) phase. Immune checkpoint inhibitors have been evidenced as an additional treatment option with substantial effectiveness and acceptable toxicity in heavily pretreated patients with Hodgkin's lymphoma. Particularly, PD-1 blockade with nivolumab and pembrolizumab has demonstrated significant single-agent activity in this select population.
霍奇金淋巴瘤在癌症中较为特殊，因为它在包括T细胞在内的大量免疫系统细胞中仅由少数恶性霍奇金/里德-斯腾伯格细胞组成。这些T细胞大多以不同方式可逆性失活，其重新激活可能会引发对癌细胞非常强烈的免疫反应。T细胞重新激活的一种方法是使用阻断CTLA-4的抗体，尤其是使用针对PD-1或PD-L1配体的抗体，从而逆转肿瘤诱导的T细胞功能下调，并在启动阶段（CTLA-4）或组织效应阶段（PD-1）增强抗肿瘤免疫活性。免疫检查点抑制剂已被证明是一种额外的治疗选择，对经过大量预处理的霍奇金淋巴瘤患者具有显著疗效且毒性可接受。特别是，纳武单抗和派姆单抗阻断PD-1在这一特定人群中已显示出显著的单药活性。
