Division of Gynecologic Oncology, Segal Cancer Center, Lady Davis Institute of Research, Jewish General Hospital, McGill University, Montreal, Canada.
Division of Gynecologic Oncology, Segal Cancer Center, Lady Davis Institute of Research, Jewish General Hospital, McGill University, Montreal, Canada.
Best Pract Res Clin Obstet Gynaecol. 2019 Oct;60:97-110. doi: 10.1016/j.bpobgyn.2019.03.005. Epub 2019 Mar 21.
Oncology treatments have evolved from intuitive, via empiric, to the present precision medicine, with the integration of molecular targeted therapies in our treatment arsenal. The use of the patients' powerful immune system has long been contemplated and recently led to the integration of immunotherapy to overturn the well-documented inhibitory effects of the tumor on the immune system and restore it to a state of activity against the cancer. Recent favorable results have shown the value and effectiveness of immunotherapy against gynecological cancers. In particular, the checkpoint inhibitors, targeting the programmed death-1 (PD-1) pathway, have shown durable clinical responses with manageable toxicity. Several phase II and III clinical trials testing the association of different regimen of chemotherapy and immunotherapy are ongoing in gynecological cancers, and important results are expected. In this chapter, we outline the main principles of immunotherapy for gynecological cancers and summarize the current strategies used in clinical trials.
肿瘤治疗已经从直观的、经验性的发展到目前的精准医学，分子靶向治疗已经融入我们的治疗武器库。利用患者强大的免疫系统一直是我们所考虑的，最近免疫疗法的应用颠覆了肿瘤对免疫系统的抑制作用，并使其恢复到对抗癌症的活跃状态。最近的研究结果表明免疫疗法在妇科肿瘤中的价值和有效性。特别是，针对程序性死亡受体-1 (PD-1) 通路的检查点抑制剂显示出持久的临床反应，且毒性可管理。在妇科肿瘤中，正在进行几项测试不同化疗和免疫疗法联合方案的 II 期和 III 期临床试验，预计将有重要的结果。在这一章中，我们概述了妇科肿瘤免疫治疗的主要原则，并总结了目前临床试验中使用的策略。
