Grimm M-O, Winkler Y, Fetter I, Oppel-Heuchel H
Urologische Klinik und Poliklinik, Universitätsklinikum Jena, Lessingstraße 1, 07749, Jena, Deutschland.
Urologe A. 2016 May;55(5):621-6. doi: 10.1007/s00120-016-0107-4.
With the advent of immune checkpoint inhibitors, immunotherapy has gained new importance in oncology. Current research is focused on the cytotoxic T‑lymphocyte antigen 4 (CTLA4), programmed cell death 1 (PD-1) and programmed death ligand 1 (PD-L1) immune checkpoints. The CTLA4 antibody ipilimumab (melanoma) as well as the PD-1 antibodies nivolumab (melanoma, non-small cell lung cancer and renal cell carcinoma) and pembrolizumab (melanoma) are approved for the treatment of metastatic disease in Europe. Immune checkpoint inhibitors (re)activate the immune system against cancer cells and appear to be more effective than current standards for many tumors. The toxicity profile is favorable but involves new so-called immune-related side effects, which need to be recognized and treated in time. Immune checkpoint inhibitors are also currently being tested in uro-oncology in phase 3 trials relevant for approval status. Based on this it is to be expected that immune checkpoint inhibitors will become a new standard (as monotherapy or as part of combination therapy) in the early lines of therapy in the near future and replace the previous standard therapies, particularly for metastasized renal cell carcinoma and urothelial cancer.
随着免疫检查点抑制剂的出现,免疫疗法在肿瘤学领域获得了新的重要地位。当前的研究集中在细胞毒性T淋巴细胞抗原4(CTLA4)、程序性细胞死亡蛋白1(PD-1)和程序性死亡配体1(PD-L1)免疫检查点。CTLA4抗体伊匹单抗(用于治疗黑色素瘤)以及PD-1抗体纳武单抗(用于治疗黑色素瘤、非小细胞肺癌和肾细胞癌)和帕博利珠单抗(用于治疗黑色素瘤)在欧洲已被批准用于治疗转移性疾病。免疫检查点抑制剂可(重新)激活针对癌细胞的免疫系统,并且对于许多肿瘤而言似乎比当前的标准疗法更有效。其毒性特征良好,但会出现新的所谓免疫相关副作用,需要及时识别和治疗。免疫检查点抑制剂目前也正在泌尿肿瘤学领域进行3期试验,这些试验与批准状态相关。基于此,可以预期免疫检查点抑制剂在不久的将来将成为早期治疗方案中的新标准(作为单一疗法或联合疗法的一部分),并取代先前的标准疗法,特别是对于转移性肾细胞癌和尿路上皮癌。