Oliveres Helena, Caglevic Christian, Passiglia Francesco, Taverna Simona, Smits Evelien, Rolfo Christian
Phase I-Early Clinical Trials Unit, Antwerp University Hospital, Edegem, Belgium.
Department of Oncology, Parc Taulí Hospital, Sabadell, Spain.
J Thorac Dis. 2018 May;10(Suppl 13):S1602-S1614. doi: 10.21037/jtd.2018.05.134.
Despite new advances in therapeutics, lung cancer remains the first cause of mortality among different types of malignancies. To improve survival, different strategies have been developed such as chemotherapy combinations, targeted therapies and more recently immunotherapy. Immunotherapy is based on the capability of the immune system to differentiate cancer cells from normal cells to fight against the tumor. The two main checkpoint inhibitors that have been widely studied in non-small cell lung cancer (NSCLC) are PD-1/PD-L1 and CTLA-4. However, interactions between tumor and immune system are much more complex with several different elements that take part and probably many new interactions to be discovered and studied for a better comprehension of those pathways. Vaccines are part of the prophylaxis and of the treatment for different infectious diseases. For that reason, they have allowed us to improve global survival worldwide. This same idea can be used for cancer treatment. First reports in clinical trials that used therapeutic vaccines in NSCLC were discouraging, but currently vaccines have a new chance in cancer therapy with the identification of new targetable antigens, adjuvant treatments and most interestingly, the combination of vaccines with anti-PD-1/PD-L1 and anti-CTLA-4 drugs. The aim of this article is to describe the scientific evidence that has been reported for the different types of vaccines and their mechanisms of action in the fight against NSCLC tumors to improve disease control.
尽管治疗方法有了新进展,但肺癌仍是各类恶性肿瘤中致死率最高的疾病。为提高生存率,人们开发了多种策略,如联合化疗、靶向治疗,以及最近的免疫治疗。免疫治疗的基础是免疫系统区分癌细胞和正常细胞以对抗肿瘤的能力。在非小细胞肺癌(NSCLC)中得到广泛研究的两种主要检查点抑制剂是PD-1/PD-L1和CTLA-4。然而,肿瘤与免疫系统之间的相互作用要复杂得多,有几种不同的因素参与其中,可能还有许多新的相互作用有待发现和研究,以便更好地理解这些途径。疫苗是不同传染病预防和治疗的一部分。因此,它们使我们能够提高全球的生存率。同样的理念也可用于癌症治疗。在NSCLC中使用治疗性疫苗的临床试验的最初报告令人沮丧,但目前随着新的可靶向抗原的鉴定、辅助治疗,以及最引人注目的是疫苗与抗PD-1/PD-L1和抗CTLA-4药物的联合使用,疫苗在癌症治疗中有了新的契机。本文的目的是描述已报道的不同类型疫苗的科学证据及其在对抗NSCLC肿瘤以改善疾病控制方面的作用机制。