纳武单抗进行的检查点免疫疗法用于治疗转移性黑色素瘤。

Checkpoint immunotherapy by nivolumab for treatment of metastatic melanoma.

作者信息

Koppolu Veerendra, Rekha Vasigala Veneela Krishna

机构信息

Department of Molecular Biosciences, University of Kansas, Lawrence, KS, USA.

Department of General Medicine, Rangaraya Medical College, NTR University of Health Sciences, Vijayawada, Andhra Pradesh, India.

出版信息

J Cancer Res Ther. 2018 Oct-Dec;14(6):1167-1175. doi: 10.4103/jcrt.JCRT_1290_16.

Abstract

Clinical management of metastatic melanoma suffered historically from a lack of effective targeted and immunotherapies due to short-lived clinical responses. Recent advances in our understanding of tumor-immune signaling pathways, discovery of immunosuppressive checkpoints, and subsequent development of antibodies that target these checkpoints reverses the situation to some extent. Two antibodies ipilimumab and nivolumab gained Food and Drug administration approval for the treatment of metastatic melanoma and target two major immunosuppressive checkpoints cytotoxic T lymphocyte antigen and programmed cell death protein 1 (PD-1), respectively. Nivolumab binds to PD-1, prevents PD-1 interaction with ligand Programmed death ligand 1 (PD-L1), and thus releases the T-cell exhaustion events (such as T cell apoptosis, decrease in T cell proliferation, etc.) leading to buildup of potent tumor-specific immune response. Successful Phase I-III results with remarkable antitumor activity and safety led to approval of nivolumab against ipilimumab refractory metastatic melanoma. Nivolumab therapy is exciting in that it not only provides substantial benefit but also provides durable responses. This review focuses on the evolution of immunotherapy leading to nivolumab approval and its potential in treating melanoma either alone or in combination with other therapies.

摘要

由于临床反应短暂,转移性黑色素瘤的临床管理在历史上一直缺乏有效的靶向和免疫疗法。近年来,我们对肿瘤免疫信号通路的理解取得了进展,发现了免疫抑制检查点,随后开发的针对这些检查点的抗体在一定程度上扭转了这种局面。两种抗体伊匹单抗和纳武单抗分别获得了美国食品药品监督管理局(FDA)批准用于治疗转移性黑色素瘤,它们分别靶向两个主要的免疫抑制检查点,即细胞毒性T淋巴细胞抗原和程序性细胞死亡蛋白1(PD-1)。纳武单抗与PD-1结合,阻止PD-1与配体程序性死亡配体1(PD-L1)相互作用,从而解除导致强大的肿瘤特异性免疫反应积累的T细胞耗竭事件(如T细胞凋亡、T细胞增殖减少等)。纳武单抗在I-III期试验中取得了成功,具有显著的抗肿瘤活性和安全性,因此被批准用于治疗对伊匹单抗难治的转移性黑色素瘤。纳武单抗疗法令人兴奋之处在于,它不仅带来了实质性益处,还产生了持久的疗效。本综述重点关注导致纳武单抗获批的免疫疗法的发展历程及其单独或与其他疗法联合治疗黑色素瘤的潜力。

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