Clinic Oncomed, Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil.
Oncomed Clinic Oncologica, Niterói, Rio de Janeiro, 24220-300, Brazil.
Cancer Chemother Pharmacol. 2019 Aug;84(2):227-240. doi: 10.1007/s00280-019-03894-3. Epub 2019 Jun 25.
For many decades, cancer treatment has been strongly directed toward the development of cytotoxic and cytostatic drugs, quite often leading to disappointing results due to the inter- and intra-tumoral heterogeneity. Lately, this intra-cellular look has given way to the understanding of the tumor microenvironment, thus enabling modification of the immunological dynamics between tumor cells and their host. An era of new drugs aiming to unlock the host immune system against tumor cells is steadily increasing. Strategies involving adoptive cell therapy, therapeutic vaccines, immune checkpoint inhibitors and so on have provided spectacular clinical responses and increased survival in previously refractory settings and "hard-to-treat" cancers. Based on a comprehensive search in the main scientific databases, annals of recent renowned oncology congresses and platforms of ongoing trials, the clinical pharmacology characteristics of the main classes of immunotherapeutic agents, as well as the new treatment strategies related to immunotherapy in solid tumors, are carefully discussed throughout this review.
几十年来,癌症治疗一直强烈地指向细胞毒性和细胞抑制药物的发展,由于肿瘤内和肿瘤间的异质性,往往导致令人失望的结果。最近,这种细胞内的观察方式已经让位于对肿瘤微环境的理解,从而能够改变肿瘤细胞与其宿主之间的免疫动力学。旨在利用宿主免疫系统对抗肿瘤细胞的新型药物时代正在稳步增加。涉及过继细胞疗法、治疗性疫苗、免疫检查点抑制剂等的策略为以前难以治疗的难治性环境和“难治疗”癌症提供了显著的临床反应和生存率的提高。基于对主要科学数据库、最近著名肿瘤学大会的纪事和正在进行的试验平台的全面搜索,本文仔细讨论了免疫治疗剂的主要类别以及与实体瘤免疫治疗相关的新治疗策略的临床药理学特征。
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