Alley Evan W, Katz Sharyn I, Cengel Keith A, Simone Charles B
Hematology and Oncology Division, Penn Presbyterian Medical Center, University of Pennsylvania Health System, Philadelphia, PA, USA.
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Transl Lung Cancer Res. 2017 Apr;6(2):212-219. doi: 10.21037/tlcr.2017.04.01.
Malignant pleural mesothelioma (MPM) is a particularly aggressive thoracic malignancy with limited survival following combination chemotherapy. As a result, there has been increased interested in immunotherapy for mesothelioma, both in the first-line and salvage settings. Early investigations of interleukin-2 (IL-2) and interferon alfa-2a/b have been limited by modest response rates and toxicity, whereas cytokine gene therapy is currently being investigated and shows early promise. The most prominent class of immunotherapies to be trialed with mesothelioma in the past half-decade has been immune checkpoint inhibitors (CPI). Early results are encouraging, particularly for agents targeting the PD-1/PD-L1 pathways. With the increasing recognition of the immune potential of mesothelioma, interest in the immunomodulatory properties of radiation therapy has emerged. The combination of immunotherapy and radiation therapy may allow for complimentary immunologic effects that can enhance antitumor response. This article reviews the existing literature on the efficacy of immunotherapy for MPM, describes the rationale for combining immunotherapy with radiation therapy, and discusses early literature on this treatment combination.
恶性胸膜间皮瘤（MPM）是一种侵袭性很强的胸部恶性肿瘤，联合化疗后的生存期有限。因此，无论是一线治疗还是挽救治疗，间皮瘤免疫治疗都越来越受到关注。白细胞介素-2（IL-2）和干扰素α-2a/b的早期研究受到缓解率适中及毒性的限制，而细胞因子基因治疗目前正在研究中，并显示出早期前景。在过去五年中，与间皮瘤一起试验的最突出的免疫治疗类别是免疫检查点抑制剂（CPI）。早期结果令人鼓舞，特别是针对PD-1/PD-L1通路的药物。随着对间皮瘤免疫潜力的认识不断提高，人们对放射治疗的免疫调节特性产生了兴趣。免疫治疗与放射治疗的联合应用可能会产生互补的免疫效应，从而增强抗肿瘤反应。本文综述了MPM免疫治疗疗效的现有文献，描述了免疫治疗与放射治疗联合应用的原理，并讨论了关于这种治疗联合的早期文献。
