Renner Alex, Burotto Mauricio, Rojas Carlos
University of Chile Clinical Hospital, Santiago, Chile.
Los Andes University, Santiago, Chile.
J Glob Oncol. 2019 Jul;5:1-5. doi: 10.1200/JGO.19.00142.
In just a few years, immune checkpoint inhibitors have dramatically changed the landscape in oncology, offering durable responses and improved survival for many patients across several tumor types. With more than 3,300 new agents in the immuno-oncology pipeline plus a wide array of combinations being studied, it seems this new era is just getting started. These advances come with a significant caveat: most of the world population does not have access to their benefits, because the yearly cost of a novel anticancer medication can routinely exceed $100,000. There is a large amount of data showing that checkpoint inhibitors have significant activity at doses much lower than those currently approved. We review the evidence for reduced drug dosing as a strategy to increase the number of patients who can be treated and what would be needed to further validate this approach.
在短短几年内，免疫检查点抑制剂极大地改变了肿瘤学领域的格局，为多种肿瘤类型的许多患者带来了持久的反应并提高了生存率。免疫肿瘤学研发管道中有3300多种新药物，同时还有大量联合用药正在研究，看来这个新时代才刚刚开始。这些进展伴随着一个重大问题：世界上大多数人口无法受益于这些药物，因为一种新型抗癌药物的年费用通常会超过10万美元。大量数据表明，检查点抑制剂在远低于目前批准剂量的情况下就具有显著活性。我们回顾了降低药物剂量作为增加可治疗患者数量的策略的证据，以及进一步验证该方法所需的条件。
