Department of Medical Oncology.
Department of Pathology, Centre Leon Berard, Lyon, France.
Curr Opin Oncol. 2019 Jul;31(4):304-309. doi: 10.1097/CCO.0000000000000548.
Development of immune therapy in sarcoma faces the rarity and heterogeneity of the disease. This review analyses the data available from published clinical trials, and the new clinical strategies under assessment, developed in parallel to the exploration of biological mechanisms underlying the efficacy of immune therapy.
Published data of four clinical trials assessing the efficacy of immune therapy in metastatic bone and soft-tissue sarcoma and associated translational programs are available. Response rate and progression-free survival with single-agent immune check point blockade in unselected sarcoma are low. No biomarkers of efficacy have been identified so far. To increase the efficacy of such treatments, combination of immune check point blockade with chemotherapy, radiotherapy or targeted therapy is currently assessed. Signal of specific sensibility of some histological subtypes is explored. Adoptive cell therapy or vaccine seems particularly promising in translocation-associated sarcoma.
Characterization of immune environment, mechanism of action of combined regimen and identification of biomarkers will be key steps to build the next clinical trials to improve the efficacy of such strategy.
肉瘤的免疫治疗发展面临着疾病的罕见性和异质性。这篇综述分析了已发表的临床试验数据，以及在探索免疫治疗疗效的生物学机制的同时评估的新的临床策略。
有四项评估免疫治疗在转移性骨和软组织肉瘤中的疗效的临床试验的相关数据发表，以及相关的转化研究。在未经选择的肉瘤患者中，单药免疫检查点阻断的反应率和无进展生存期较低。目前尚未确定任何疗效的生物标志物。为了提高这些治疗的疗效，目前正在评估免疫检查点阻断与化疗、放疗或靶向治疗的联合应用。一些组织学亚型的特定敏感性信号正在被探索。在易位相关肉瘤中，过继细胞治疗或疫苗似乎特别有希望。
免疫环境的特征、联合方案的作用机制和生物标志物的鉴定将是构建临床试验的关键步骤，以提高这种策略的疗效。
