a Department of Medicine, Division of Solid Tumor Oncology, Genitourinary Oncology Service , Memorial Sloan Kettering Cancer Center , New York , NY , USA.
Expert Rev Anticancer Ther. 2018 Mar;18(3):215-221. doi: 10.1080/14737140.2018.1432357. Epub 2018 Jan 31.
Advanced urothelial cancer patients had limited therapeutic options following failure of platinum-based chemotherapy. The recognition that anti-PD1/PDL1 immune checkpoint inhibitors lead to dramatic and durable responses in a subset of patients has transformed the therapeutic landscape of these cancers. Since May 2016, five agents targeting this pathway have been approved by the US FDA, including the PD-1 inhibitor nivolumab. Areas covered: The purpose of this paper was to review the safety, activity and efficacy of nivolumab, an anti-PD1 checkpoint inhibitor for the treatment of locally-advanced or metastatic urothelial cancers. Future therapeutic perspectives were also discussed. Expert commentary: Nivolumab is one of five anti-PD1/PDL1 checkpoint inhibitors approved for treatment of advanced urothelial cancers. While durable responses can be observed, only 15 - 24% of patients are likely to respond. To date, there are no validated biomarkers, including PDL1 expression, which might accurately identify patients who are likely to respond. Many different biomarkers are currently under active investigation. Future direction for therapeutic development is likely to involve combination therapies with PD1/PDL1 agent as the therapeutic backbone.
晚期尿路上皮癌患者在铂类化疗失败后治疗选择有限。抗 PD1/PDL1 免疫检查点抑制剂在部分患者中引起显著和持久反应，这改变了这些癌症的治疗格局。自 2016 年 5 月以来，五种针对该途径的药物已获得美国 FDA 批准，包括 PD-1 抑制剂纳武利尤单抗。
本文旨在回顾抗 PD1 检查点抑制剂纳武利尤单抗治疗局部晚期或转移性尿路上皮癌的安全性、活性和疗效。还讨论了未来的治疗前景。
纳武利尤单抗是批准用于治疗晚期尿路上皮癌的五种抗 PD1/PDL1 检查点抑制剂之一。虽然可以观察到持久的反应，但只有 15-24%的患者可能有反应。迄今为止，尚无经过验证的生物标志物，包括 PDL1 表达，可准确识别可能有反应的患者。目前有许多不同的生物标志物正在积极研究中。未来的治疗发展方向可能涉及以 PD1/PDL1 药物为治疗骨干的联合治疗。
