血液系统恶性肿瘤中的检查点抑制剂

Checkpoint inhibitors in hematological malignancies.

作者信息

Ok Chi Young, Young Ken H

机构信息

Department of Hematopathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030-4009, USA.

出版信息

J Hematol Oncol. 2017 May 8;10(1):103. doi: 10.1186/s13045-017-0474-3.

Abstract

Inhibitory molecules such as PD-1, CTLA-4, LAG-3, or TIM-3 play a role to keep a balance in immune function. However, many cancers exploit such molecules to escape immune surveillance. Accumulating data support that their functions are dysregulated in lymphoid neoplasms, including plasma cell myeloma, myelodysplastic syndrome, and acute myeloid leukemia. In lymphoid neoplasms, aberrations in 9p24.1 (PD-L1, PD-L2, and JAK2 locus), latent Epstein-Barr virus infection, PD-L1 3'-untranslated region disruption, and constitutive JAK-STAT pathway are known mechanisms to induce PD-L1 expression in lymphoma cells. Clinical trials demonstrated that PD-1 blockade is an attractive way to restore host's immune function in hematological malignancies, particularly classical Hodgkin lymphoma. Numerous clinical trials exploring PD-1 blockade as a single therapy or in combination with other immune checkpoint inhibitors in patients with hematologic cancers are under way. Although impressive clinical response is observed with immune checkpoint inhibitors in patients with certain cancers, not all patients respond to immune checkpoint inhibitors. Therefore, to identify best candidates who would have excellent response to checkpoint inhibitors is of utmost importance. Several possible biomarkers are available, but consensus has not been made and pursuit to discover the best biomarker is ongoing.

摘要

诸如PD-1、CTLA-4、LAG-3或TIM-3等抑制性分子在维持免疫功能平衡方面发挥作用。然而,许多癌症利用这些分子逃避免疫监视。越来越多的数据支持它们的功能在包括浆细胞骨髓瘤、骨髓增生异常综合征和急性髓系白血病在内的淋巴系统肿瘤中失调。在淋巴系统肿瘤中,9p24.1(PD-L1、PD-L2和JAK2基因座)的畸变、潜伏的EB病毒感染、PD-L1 3'非翻译区的破坏以及组成性JAK-STAT途径是诱导淋巴瘤细胞中PD-L1表达的已知机制。临床试验表明,PD-1阻断是恢复血液系统恶性肿瘤尤其是经典型霍奇金淋巴瘤宿主免疫功能的一种有吸引力的方法。许多探索将PD-1阻断作为单一疗法或与其他免疫检查点抑制剂联合用于血液系统癌症患者的临床试验正在进行。尽管在某些癌症患者中使用免疫检查点抑制剂观察到了令人印象深刻的临床反应,但并非所有患者都对免疫检查点抑制剂有反应。因此,识别对检查点抑制剂有出色反应的最佳候选者至关重要。有几种可能的生物标志物,但尚未达成共识,对发现最佳生物标志物的探索仍在进行中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8333/5422942/264f8950528d/13045_2017_474_Fig1_HTML.jpg

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