Krajsová I
Klin Onkol. 2017 Winter;30(Supplementum3):40-44. doi: 10.14735/amko20173S40.
Development of immunotherapy has dramatically changed poor prognosis of metastatic malignant melanoma (MM). Inhibition of immune checkpoints represents a new effective treatment. Monoclonal antibodies against CTLA-4 ipilimumab and against PD-1 (programme death 1) nivolumab and pembrolizumab prolong progression free survival and overall survival (OS) in patients with advanced metastatic MM. Both achieved significant improvement in relapse-free survival and OS also in adjuvant setting. It looks like the efficacy of the combined immunotherapy of ipilimumab with anti-PD-1 antibodies is superior to the monotherapy, but combined therapy is accompanied by higher toxicity. Management of adverse events of ipilimumab plus nivolumab combination were solved in several clinical trials. New combinations such as immunotherapy with intralesional oncolytic vaccination are explored. In this review, some results of clinical trials presented at ASCO (American Society of Clinical Oncology) 2017 are mentioned. Interesting data were obtained from the evaluation of long-term efficacy of immunotherapy in patients who had to stop the treatment for adverse events. Other trial (CheckMate 172) evaluated the safety and efficiency of nivolumab in MM patients who failed on or after therapy with ipilimumab. Considerable attention has been paid to the efficacy of immunotherapy in the treatment of brain metastases.Key words: malignant melanoma - immunotherapy - ipilimumab - nivolumab - pembrolizumab - talimogene laherparepvec - brain metastases The author declares she no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 31. 8. 2017Accepted: 24. 10. 2017.
免疫疗法的发展极大地改变了转移性恶性黑色素瘤(MM)的不良预后。免疫检查点抑制代表了一种新的有效治疗方法。抗CTLA-4的单克隆抗体伊匹单抗以及抗PD-1(程序性死亡蛋白1)的纳武单抗和派姆单抗可延长晚期转移性MM患者的无进展生存期和总生存期(OS)。在辅助治疗中,两者在无复发生存期和OS方面也都取得了显著改善。伊匹单抗与抗PD-1抗体联合免疫疗法的疗效似乎优于单一疗法,但联合疗法的毒性更高。在多项临床试验中解决了伊匹单抗加纳武单抗联合治疗的不良事件管理问题。正在探索新的联合疗法,如病灶内溶瘤疫苗免疫疗法。在本综述中,提到了2017年美国临床肿瘤学会(ASCO)上公布的一些临床试验结果。从对因不良事件而不得不停止治疗的患者进行免疫疗法长期疗效评估中获得了有趣的数据。另一项试验(CheckMate 172)评估了纳武单抗在伊匹单抗治疗失败或之后的MM患者中的安全性和有效性。免疫疗法在脑转移瘤治疗中的疗效受到了相当大的关注。关键词:恶性黑色素瘤 - 免疫疗法 - 伊匹单抗 - 纳武单抗 - 派姆单抗 - 塔利莫基因拉哈帕里韦克 - 脑转移瘤 作者声明她在研究中使用药物、产品或服务方面不存在潜在利益冲突。编辑委员会声明该手稿符合ICMJE对生物医学论文的建议。提交日期:2017年8月31日 接受日期:2017年10月24日