Gaillard Stéphanie L, Secord Angeles A, Monk Bradley
Department of Medicine, Division of Medical Oncology, Duke Cancer Institute, 200 Trent Drive, Durham, NC 27710 USA.
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Duke Cancer Institute, 200 Trent Drive, Durham, NC 27710 USA.
Gynecol Oncol Res Pract. 2016 Nov 24;3:11. doi: 10.1186/s40661-016-0033-6. eCollection 2016.
The introduction of immune checkpoint inhibitors has revolutionized treatment of multiple cancers and has bolstered interest in this treatment approach. So far, emerging clinical data show limited clinical efficacy of these agents in ovarian cancer with objective response rates of 10-15% with some durable responses. In this review, we present emerging clinical data of completed trials of immune checkpoint inhibitors and review ongoing studies. In addition we examine the current knowledge of the tumor microenvironment of ovarian cancers with a focus on the significance of PD-L1 expression and tumor-infiltrating lymphocytes on predicting response to immune checkpoint blockade. We evaluate approaches to improve treatment outcomes through the use of predictive biomarkers and patient selection. Finally, we review management considerations including immune related adverse events and response criteria.
免疫检查点抑制剂的引入彻底改变了多种癌症的治疗方式，并激发了人们对这种治疗方法的兴趣。到目前为止，新出现的临床数据显示，这些药物在卵巢癌中的临床疗效有限，客观缓解率为10%-15%，部分缓解持久。在本综述中，我们展示了免疫检查点抑制剂已完成试验的新出现临床数据，并回顾了正在进行的研究。此外，我们研究了目前对卵巢癌肿瘤微环境的认识，重点关注PD-L1表达和肿瘤浸润淋巴细胞在预测免疫检查点阻断反应中的意义。我们评估通过使用预测性生物标志物和患者选择来改善治疗结果的方法。最后，我们回顾了管理方面的考虑因素，包括免疫相关不良事件和反应标准。
