Oncology (Williston Park). 2019 Jan 17;33(1):11-8.
Immune checkpoint inhibitors have revolutionized the field of oncology, providing a novel mechanism for anticancer therapy. Programmed death 1-targeting antibodies pembrolizumab and nivolumab and programmed death ligand 1 (PD-L1)-targeting antibodies atezolizumab, durvalumab, and avelumab have been approved for use in advanced urothelial cancer in the post-platinum setting or in the upfront setting in platinum-ineligible patients. While this represents a significant step forward in management of urothelial cancers, most patients do not have an objective response to these therapies. PD-L1 expression is not a consistently predictive biomarker, but is recommended for checkpoint utilization in select circumstances. We report here a summary of known data and the differences between these agents, as well as future avenues to explore with immuno-oncologic agents in urothelial cancer. Much work is ongoing to better understand resistance mechanisms, to maximize efficacy with combination strategies, to find improved predictive biomarkers, to assess curative-intent strategies, and to better manage toxicity with these agents.
免疫检查点抑制剂彻底改变了肿瘤学领域，为癌症治疗提供了一种新的机制。程序性死亡 1 靶向抗体 pembrolizumab 和 nivolumab 以及程序性死亡配体 1（PD-L1）靶向抗体 atezolizumab、durvalumab 和avelumab 已被批准用于铂类治疗后或不适合铂类治疗的患者的一线治疗中晚期尿路上皮癌。虽然这代表着在管理尿路上皮癌方面迈出了重要的一步，但大多数患者对这些治疗方法没有客观的反应。PD-L1 表达不是一个始终具有预测性的生物标志物，但在某些情况下建议用于检查点的利用。我们在此报告了已知数据的摘要以及这些药物之间的差异，以及在尿路上皮癌中探索免疫肿瘤药物的未来途径。目前正在进行大量工作以更好地了解耐药机制，通过联合策略最大限度地提高疗效，寻找更好的预测生物标志物，评估有治愈意图的策略，并更好地管理这些药物的毒性。
