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癌症免疫治疗后的不良反应:挑战与机遇。

Adverse Events Following Cancer Immunotherapy: Obstacles and Opportunities.

机构信息

Department of Immunology, Blavatnik Institute, Harvard Medical School, Boston, MA 02115, USA; Evergrande Center for Immunologic Diseases, Harvard Medical School and Brigham and Women's Hospital, Boston, MA 02115, USA.

Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.

出版信息

Trends Immunol. 2019 Jun;40(6):511-523. doi: 10.1016/j.it.2019.04.002. Epub 2019 Apr 30.

Abstract

Oncology has recently undergone a revolutionary change with widespread adoption of immunotherapy for many cancers. Immunotherapy using monoclonal antibodies against checkpoint molecules, including programmed death (PD)-1, PD ligand (PD-L)1, and cytotoxic T lymphocyte-associated antigen (CTLA)-4, is effective in a significant subset of patients. However, immune-related adverse events (irAEs) have emerged as frequent complications of checkpoint blockade, likely due to the physiological role of checkpoint pathways in regulating adaptive immunity and preventing autoimmunity. As immunotherapy becomes more common, a better understanding of the etiology of irAEs and ways to limit these events is needed. At the same time, studying these new therapy-related disorders provides an opportunity to better understand naturally occurring human autoimmune and inflammatory disorders, with the potential to improve therapies for cancer and autoimmune diseases.

摘要

肿瘤学最近发生了革命性的变化,广泛采用免疫疗法治疗多种癌症。使用针对检查点分子(包括程序性死亡(PD)-1、PD 配体(PD-L)1 和细胞毒性 T 淋巴细胞相关抗原(CTLA)-4)的单克隆抗体进行免疫治疗,对相当一部分患者有效。然而,免疫相关不良事件(irAEs)已成为检查点阻断的常见并发症,这可能是由于检查点途径在调节适应性免疫和预防自身免疫中的生理作用。随着免疫疗法变得更加普遍,需要更好地了解 irAEs 的病因和限制这些事件的方法。同时,研究这些新的治疗相关疾病为更好地了解自然发生的人类自身免疫和炎症性疾病提供了机会,有可能改善癌症和自身免疫性疾病的治疗方法。

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