Medical Oncology and Immunotherapy, Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena, Italy.
Medical Oncology and Immunotherapy, Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena, Italy.
Cytokine Growth Factor Rev. 2017 Aug;36:33-38. doi: 10.1016/j.cytogfr.2017.07.002. Epub 2017 Jul 13.
Immunotherapy with monoclonal antibodies (mAb) directed to different immune check-point(s) is showing a significant clinical impact in a growing number of human tumors of different histotype, both in terms of disease response and long-term survival patients. In this rapidly changing scenario, treatment of brain metastases remains an high unmeet medical need, and the efficacy of immunotherapy in these highly dismal clinical setting remains to be largely demonstrated. Nevertheless, up-coming observations are beginning to suggest a clinical potential of cancer immunotherapy also in brain metastases, regardless the underlying tumor histotype. These observations remain to be validated in larger clinical trials eventually designed also to address the efficacy of therapeutic mAb to immune check-point(s) within multimodality therapies for brain metastases. Noteworthy, the initial proofs of efficacy on immunotherapy in central nervous system metastases are already fostering clinical trials investigating its therapeutic potential also in primary brain tumors. We here review ongoing immunotherapeutic approaches to brain metastases and primary brain tumors, and the foreseeable strategies to overcome their main biologic hurdles and clinical challenges.
免疫疗法与单克隆抗体（mAb）针对不同的免疫检查点（s）在越来越多的不同组织类型的人类肿瘤中显示出显著的临床影响，无论是在疾病反应还是长期生存患者方面。在这种快速变化的情况下，脑转移瘤的治疗仍然是一个巨大的未满足的医疗需求，免疫疗法在这些高度恶劣的临床环境中的疗效仍有待大量证明。然而，即将出现的观察结果开始提示癌症免疫疗法在脑转移瘤中的临床潜力，无论其潜在的肿瘤组织类型如何。这些观察结果仍有待在更大规模的临床试验中得到验证，这些试验最终也旨在针对脑转移瘤的多模式治疗中免疫检查点的治疗性 mAb 的疗效进行评估。值得注意的是，免疫疗法在中枢神经系统转移瘤中的初步疗效证明已经促进了临床试验，以研究其在原发性脑肿瘤中的治疗潜力。在这里，我们回顾了针对脑转移瘤和原发性脑肿瘤的正在进行的免疫治疗方法，以及可预见的克服其主要生物学障碍和临床挑战的策略。
