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西莫单抗-EGF,一种治疗非小细胞肺癌的疫苗。

CIMAvax-EGF, a therapeutic non-small cell lung cancer vaccine.

机构信息

a Lung Cancer Unit , Ospedale Policlinico San Martino , Genoa , Italy.

b Department of Internal Medicine and Medical Specialties (DIMI) , University of Genoa , Genoa , Italy.

出版信息

Expert Opin Biol Ther. 2018 Jul;18(7):829-835. doi: 10.1080/14712598.2018.1492539. Epub 2018 Jul 4.

Abstract

Lung cancer represents the most common cause of cancer death worldwide. While the prognosis remains poor, immunotherapy is giving a positive impact on survival. Cancer vaccines represent a form of active immunotherapy that historically has given modest results in terms of efficacy. The overexpression of the EGFR by tumor cells was reported in more than half of cases of lung cancer, representing a mechanism of cancerogenesis. CIMAvax-EGF, a therapeutic vaccine for non-small cell lung cancer (NSCLC) developed in Cuba, consists of a human recombinant EGF able to induce antibodies against the autologous EGF, resulting in serum EGF withdrawal and lower EGF-EGFR interaction. Area covered: We critically reviewed the existing literature about CIMAvax-EGF, from the Pilot studies to the efficacy controlled studies. We also overviewed the ongoing trials. Expert opinion: CIMAvax-EGF demonstrated to be safe and immunogenic. In a phase III randomized study CIMAvax-EGF, used as a switch maintenance treatment after platinum-based chemotherapy, did not significantly improve survival. Current data are not sufficient to recommend CIMAvax-EGF as a treatment option for advanced stage NSCLC. Further studies, conducted in a context of worldwide standardized clinical practice, are needed to better define if a subpopulation of patients can benefit from the vaccination.

摘要

肺癌是全球癌症死亡的最常见原因。虽然预后仍然较差,但免疫疗法对生存有积极影响。癌症疫苗代表了一种主动免疫疗法,在疗效方面历史上取得了适度的结果。肿瘤细胞中 EGFR 的过表达在超过一半的肺癌病例中被报道,代表了一种癌症发生机制。CIMAvax-EGF 是古巴开发的一种用于非小细胞肺癌(NSCLC)的治疗性疫苗,由能够诱导针对自体 EGF 的抗体的人重组 EGF 组成,导致血清 EGF 撤出和较低的 EGF-EGFR 相互作用。涵盖领域:我们批判性地审查了关于 CIMAvax-EGF 的现有文献,从初步研究到疗效对照研究。我们还概述了正在进行的试验。专家意见:CIMAvax-EGF 被证明是安全和免疫原性的。在一项 III 期随机研究中,CIMAvax-EGF 作为铂类化疗后的切换维持治疗,并未显著改善生存。目前的数据不足以推荐 CIMAvax-EGF 作为晚期 NSCLC 的治疗选择。需要在全球标准化临床实践的背景下进行进一步的研究,以更好地确定是否可以使一部分患者受益于疫苗接种。

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