Musacchio Lucia, Boccia Serena Maria, Caruso Giuseppe, Santangelo Giusi, Fischetti Margherita, Tomao Federica, Perniola Giorgia, Palaia Innocenza, Muzii Ludovico, Pignata Sandro, Benedetti Panici Pierluigi, Di Donato Violante
Department of Maternal and Child Health and Urological Sciences, University of Rome "Sapienza", Policlinico "Umberto I", 00161 Rome, Italy.
Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy.
J Clin Med. 2020 Jun 3;9(6):1721. doi: 10.3390/jcm9061721.
Although around 80% of endometrial cancers are diagnosed at early stages and present with a 5-year survival rate exceeding 95%, patients with advanced and recurrent disease show a poor prognosis and low response rates to standard chemotherapy. In the era of targeted therapy, the great advances in the understanding of programmed death-ligand 1 (PD-L1) upregulation in cancer cells, which is responsible for tumor immune escape, have contributed to the increasing interest in immune checkpoint inhibitors as a promising strategy for the treatment of several refractory solid malignancies, including endometrial cancer. Several clinical trials have investigated the efficacy and safety of immune checkpoint inhibitors in endometrial cancer, which already led to the approval of the anti-programmed cell death protein 1 (anti-PD-1) antibody pembrolizumab as a satisfactory alternative for selected patients with unresectable or metastatic disease. As the future of cancer treatment will probably rely on combination therapy strategies, currently, innovative ongoing trials are exploring the potential role of immune checkpoint inhibitors associated with chemotherapy, radiotherapy, and other targeted therapies. Moreover, further research is warranted to discover new specific biomarkers that can accurately predict the response to immunotherapy.
尽管约80%的子宫内膜癌在早期被诊断出来，其5年生存率超过95%，但晚期和复发性疾病患者的预后较差，对标准化疗的反应率较低。在靶向治疗时代，对癌细胞中程序性死亡配体1（PD-L1）上调的深入理解取得了重大进展，PD-L1上调是肿瘤免疫逃逸的原因，这使得免疫检查点抑制剂作为治疗包括子宫内膜癌在内的几种难治性实体恶性肿瘤的一种有前景的策略，受到越来越多的关注。多项临床试验研究了免疫检查点抑制剂在子宫内膜癌中的疗效和安全性，这已经导致抗程序性细胞死亡蛋白1（抗PD-1）抗体帕博利珠单抗被批准作为某些不可切除或转移性疾病患者的一种令人满意的替代治疗方法。由于癌症治疗的未来可能依赖于联合治疗策略，目前正在进行的创新性试验正在探索免疫检查点抑制剂与化疗、放疗及其他靶向治疗联合使用的潜在作用。此外，有必要进一步开展研究以发现能够准确预测免疫治疗反应的新的特异性生物标志物。
