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霍奇金淋巴瘤中免疫检查点抑制剂带来的重生

Back to life with checkpoint inhibitors in Hodgkin lymphoma.

作者信息

Dada Reyad, Zekri Jamal

机构信息

1 King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia.

2 College of Medicine, Al-Faisal University, Riyadh, Kingdom of Saudi Arabia.

出版信息

J Oncol Pharm Pract. 2018 Mar;24(2):139-142. doi: 10.1177/1078155216685166. Epub 2016 Dec 20.

Abstract

Cancer can escape the immune system through different mechanisms. One of which is the expression of program death ligand-1 (PD-L1). This ligand binds to programmed cell death 1 receptor on activated T cells, subsequently leading to inhibition of the immune response. Nivolumab is a novel antibody that binds to programmed cell death 1 and prevents such immune tolerance. Several recently published clinical trials confirmed the clinical efficacy of single agent nivolumab in pretreated patients with different cancer types. Publications on nivolumab in Hodgkin lymphoma are very scarce. We report on a 30-year-old man with stage IVB Hodgkin lymphoma, who failed nine lines of treatments including high-dose chemotherapy and autologous stem cell transplantation and brentuximab vedotin. He reached a major response after four cycles of nivolumab and got married. The available literature is being reviewed. Pre-treated Hodgkin lymphoma is amenable to novel immunotherapy. Nivolumab induces clinically meaningful responses with excellent tolerance. The drug enriches our treatment options by reviving the immune system response against cancer. Further clinical studies are needed to determine the effectiveness on a large patients' cohort.

摘要

癌症可通过不同机制逃避免疫系统。其中之一是程序性死亡配体-1(PD-L1)的表达。该配体与活化T细胞上的程序性细胞死亡1受体结合,随后导致免疫反应受到抑制。纳武单抗是一种新型抗体,它能与程序性细胞死亡1结合并防止这种免疫耐受。最近发表的几项临床试验证实了纳武单抗单药治疗不同癌症类型的预处理患者的临床疗效。关于纳武单抗治疗霍奇金淋巴瘤的文献非常稀少。我们报告了一名30岁的IVB期霍奇金淋巴瘤男性患者,他在接受包括大剂量化疗、自体干细胞移植和本妥昔单抗在内的九线治疗后均告失败。在接受四个周期的纳武单抗治疗后,他获得了显著缓解,并结婚了。现有的文献正在进行综述。预处理的霍奇金淋巴瘤适合采用新型免疫疗法。纳武单抗可诱导具有临床意义的反应,且耐受性良好。该药物通过恢复免疫系统对癌症的反应,丰富了我们的治疗选择。需要进一步的临床研究来确定其对大量患者群体的有效性。

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