Melichar B, Spisarová M
Klin Onkol. 2017 Winter;30(Supplementum3):45-49. doi: 10.14735/amko20173S45.
The advent of immunotherapy has changed our concept of how to manage metastatic disease. With the exception of relatively rare tumors, the treatment of metastatic cancer is still considered as palliative, and in systemic treatment immunotherapy is often selected, considering better tolerance. Immunotherapy opens the perspective of a long-term, possibly durable, response, and, in contrast to other approaches to targeted therapy, is active across a spectrum of tumors. Combined regimens that increase the efficacy, given the context, are thus of importance. The most promising results are currently obtained using a combination of ipilimumab and nivolumab for the treatment of metastatic malignant melanoma and metastatic renal cell carcinoma. Toxicity of the treatment can be managed by supportive care, and combination immunotherapy is gradually becoming established as a standard option in the management of these two neoplastic disorders. Moreover, additional trials using a combination of ipilimumab and nivolumab to treat other tumors are underway as well as studies of other combinations, including those that employ antibodies acting on immune checkpoints in combination with other targeted agents or cytotoxic chemotherapy. Other options include combinations with surgical therapy, i.e., adjuvant or neoadjuvant administration of immunotherapy or with radiotherapy based on the abscopal effect of radiation. Thus, although the results of combination immunotherapy are very promising, this strategy is still in its infancy. Thus, only the next generation of clinical trials will be able to determine to what extent these combined regimens can meet the high expectations of medical oncologists and the general public.Key words: immunotherapy - ipilimumab - nivolumab - pembrolizumab The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The authors declare they have 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: 27. 9. 2017Accepted: 3. 10. 2017.
免疫疗法的出现改变了我们对转移性疾病治疗方法的观念。除了相对罕见的肿瘤外，转移性癌症的治疗仍被视为姑息性治疗，在全身治疗中，考虑到更好的耐受性，通常会选择免疫疗法。免疫疗法开启了长期、可能持久缓解的前景，并且与其他靶向治疗方法不同，它对多种肿瘤都有活性。因此，在这种情况下，提高疗效的联合方案至关重要。目前，使用伊匹木单抗和纳武单抗联合治疗转移性恶性黑色素瘤和转移性肾细胞癌取得了最有前景的结果。治疗毒性可通过支持性护理进行管理，联合免疫疗法正逐渐成为这两种肿瘤性疾病治疗的标准选择。此外，正在进行使用伊匹木单抗和纳武单抗联合治疗其他肿瘤的额外试验，以及其他联合方案的研究，包括那些将作用于免疫检查点的抗体与其他靶向药物或细胞毒性化疗联合使用的方案。其他选择包括与手术治疗联合，即免疫疗法的辅助或新辅助给药，或基于放疗远隔效应与放疗联合。因此，尽管联合免疫疗法的结果非常有前景，但这种策略仍处于起步阶段。因此，只有下一代临床试验才能确定这些联合方案在多大程度上能够满足医学肿瘤学家和公众的高度期望。关键词：免疫疗法 - 伊匹木单抗 - 纳武单抗 - 派姆单抗 作者声明他们在研究中使用的药物、产品或服务方面没有潜在的利益冲突。作者声明他们在研究中使用的药物、产品或服务方面没有潜在的利益冲突。编辑委员会声明该手稿符合ICMJE对生物医学论文的推荐标准。提交日期：2017年9月27日 接受日期：2017年10月3日
