Department of Medicine, Division of Hematologic Malignancies, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Curr Oncol Rep. 2019 Mar 23;21(4):37. doi: 10.1007/s11912-019-0781-7.
Immune checkpoint therapy has dramatically changed the therapeutic landscape of solid malignancies. Here, we review the scientific rationale and current data evaluating immune checkpoint inhibitors in acute myeloid leukemia (AML).
Immune checkpoint inhibitor monotherapy has shown limited clinical activity in AML. Initial results from early-phase clinical trials suggest that rational combinations of immune checkpoint inhibition with hypomethylating agents (HMAs) are safe and potentially more promising. There are currently no data directly comparing immune checkpoint inhibition to standard therapies. Emerging immune targets more specific for leukemia cells including LILRB4 may improve future therapeutic efficacy. The success of immune checkpoint inhibition in AML has been modest to date. However, an improved understanding of the biology and the use of rational combinations has potential to improve rates of durable responses. Multiple clinical trials in AML are currently evaluating the use of immune checkpoints alone and in combination.
免疫检查点疗法极大地改变了实体恶性肿瘤的治疗格局。在这里,我们回顾了评估免疫检查点抑制剂在急性髓系白血病(AML)中应用的科学依据和现有数据。
免疫检查点抑制剂单药治疗在 AML 中的临床活性有限。早期临床试验的初步结果表明,免疫检查点抑制与低甲基化剂(HMAs)的合理联合是安全的,且具有更大的应用前景。目前尚无直接比较免疫检查点抑制与标准疗法的临床数据。针对白血病细胞更为特异的新兴免疫靶点,如 LILRB4,可能会提高未来的治疗效果。免疫检查点抑制在 AML 中的疗效迄今较为有限。然而,对生物学的深入了解和合理联合的应用有可能提高持久缓解率。目前,多项 AML 临床试验正在评估免疫检查点抑制剂的单独应用及其联合应用。