Orbegoso Cecilia, Murali Krithika, Banerjee Susana
Gynae Oncology Unit, The Royal Marsden NHS Foundation Trust, 203 Fulham Road, London SW3 6JJ, UK.
Rep Pract Oncol Radiother. 2018 Nov-Dec;23(6):580-588. doi: 10.1016/j.rpor.2018.05.001. Epub 2018 May 18.
Immunotherapy has been proven effective in several tumours, hence diverse immune checkpoint inhibitors are currently licensed for the treatment of melanoma, kidney cancer, lung cancer and most recently, tumours with microsatellite instability. There is much enthusiasm for investigating this approach in gynaecological cancers and the possibility that immunotherapy might become part of the therapeutic landscape for gynaecological malignancies. Cervical cancer is the fourth most frequent cancer in women worldwide and represents 7.9% of all female cancers with a higher burden of the disease and mortality in low- and middle-income countries. Cervical cancer is largely a preventable disease, since the introduction of screening tests, the recognition of the human papillomavirus (HPV) as an etiological agent, and the subsequent development of primary prophylaxis against high risk HPV subtypes. Treatment for relapsed/advanced disease has improved over the last 5 years, since the introduction of antiangiogenic therapy. However, despite advances, the median overall survival for advanced cervical cancer is 16.8 months and the 5-year overall survival for all stages is 68%. There is a need to improve outcomes and immunotherapy could offer this possibility. Clinical trials aim to understand the best timing for immunotherapy, either in the adjuvant setting or recurrent disease and whether immunotherapy, alone or in combination with other agents, improves outcomes.
免疫疗法已在多种肿瘤中被证明有效,因此目前多种免疫检查点抑制剂已获批用于治疗黑色素瘤、肾癌、肺癌,最近还用于治疗微卫星不稳定的肿瘤。人们对在妇科癌症中研究这种方法充满热情,并且免疫疗法有可能成为妇科恶性肿瘤治疗方案的一部分。宫颈癌是全球女性中第四常见的癌症,占所有女性癌症的7.9%,在低收入和中等收入国家,该病的负担和死亡率更高。宫颈癌在很大程度上是一种可预防的疾病,自从引入筛查测试、认识到人乳头瘤病毒(HPV)是病原体以及随后开发针对高危HPV亚型的一级预防措施以来。自引入抗血管生成疗法以来,复发性/晚期疾病的治疗在过去5年中有所改善。然而,尽管取得了进展,晚期宫颈癌的中位总生存期为16.8个月,所有阶段的5年总生存率为68%。有必要改善治疗结果,免疫疗法可能提供这种可能性。临床试验旨在了解免疫疗法在辅助治疗或复发性疾病中的最佳时机,以及免疫疗法单独使用或与其他药物联合使用是否能改善治疗结果。