免疫检查点抑制剂介导的肿瘤反应和不良事件的生物标志物
Biomarkers for Immune Checkpoint Inhibitor-Mediated Tumor Response and Adverse Events.
作者信息
Nakamura Yoshiyuki
机构信息
Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
出版信息
Front Med (Lausanne). 2019 May 29;6:119. doi: 10.3389/fmed.2019.00119. eCollection 2019.
In the last decade, inhibitors targeting immune checkpoint molecules such as cytotoxic T-lymphocyte antigen 4 (CTLA-4), programmed cell death 1 (PD-1), and programmed cell death-ligand 1 (PD-L1) brought about a major paradigm shift in cancer treatment. These immune checkpoint inhibitors (ICIs) improved the overall survival of a variety of cancer such as malignant melanoma and non-small lung cancer. In addition, numerous clinical trials for additional indication of ICIs including adjuvant and neo-adjuvant therapies are also currently ongoing. Therefore, more and more patients will receive ICIs in the future. However, despite the improved outcome of the cancer treatment by ICIs, the efficacy remains still limited and tumor regression have not been obtained in many cancer patients. In addition, treatment with ICIs is also associated with substantial toxicities, described as immune-related adverse events (irAEs). Therefore, biomarkers to predict tumor response and occurrence of irAEs by the treatment with ICIs are required to avoid overtreatment of ICIs and minimize irAEs development. Whereas, numerous factors have been reported as potential biomarkers for tumor response to ICIs, factors for predicting irAE have been less reported. In this review, we show recent advances in the understanding of biomarkers for tumor response and occurrence of irAEs in cancer patients treated with ICIs.
在过去十年中,靶向免疫检查点分子(如细胞毒性T淋巴细胞抗原4(CTLA-4)、程序性细胞死亡蛋白1(PD-1)和程序性细胞死亡配体1(PD-L1))的抑制剂给癌症治疗带来了重大的范式转变。这些免疫检查点抑制剂(ICIs)提高了多种癌症(如恶性黑色素瘤和非小细胞肺癌)的总生存率。此外,目前也正在进行许多关于ICIs其他适应症(包括辅助和新辅助治疗)的临床试验。因此,未来会有越来越多的患者接受ICIs治疗。然而,尽管ICIs改善了癌症治疗的结果,但疗效仍然有限,许多癌症患者并未实现肿瘤消退。此外,ICIs治疗还会引发严重的毒性反应,即免疫相关不良事件(irAEs)。因此,需要生物标志物来预测ICIs治疗的肿瘤反应和irAEs的发生,以避免ICIs的过度治疗并尽量减少irAEs的发生。尽管已有众多因素被报道为ICIs肿瘤反应的潜在生物标志物,但关于预测irAE的因素报道较少。在本综述中,我们展示了在理解接受ICIs治疗的癌症患者的肿瘤反应和irAEs发生的生物标志物方面的最新进展。
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