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恶性淋巴瘤中的免疫检查点抑制剂:进展与展望

Immune checkpoint inhibitors in malignant lymphoma: Advances and perspectives.

作者信息

Lin Ningjing, Song Yuqin, Zhu Jun

机构信息

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing 100142, China.

出版信息

Chin J Cancer Res. 2020 Jun;32(3):303-318. doi: 10.21147/j.issn.1000-9604.2020.03.03.

Abstract

Classical Hodgkin lymphoma (cHL) has been identified with universal genetic alterations of chromosome 9p24.1, which contains genes. The amplification of 9p24.1 is associated with the increased expression of and on RS cells, which promotes their immune evasion, and subsequently makes cHL sensitive to PD-1 blockade. Several PD-1 inhibitors have shown significant efficacies with overall response rate (ORR) of 70%-90% in relapse/refractory (r/r) cHL and have acquired the approvals for this indication. Recently, more and more studies are conducted to investigate PD-1 blockade in earlier disease course and in combination with neo-agents or chemotherapy. Unlike cHL, non-Hodgkin lymphoma (NHL) consists of numerous subtypes harboring highly biological heterogeneity. Only a few subtypes have been shown to have genetic alteration of including primary mediastinal B cell lymphoma (PMBL), gray zone lymphoma (GZL) with features intermediate between diffuse large B cell lymphoma (DLBCL) and cHL, primary central nervous system lymphoma (PCNSL) and primary testicular lymphoma (PTL). Epstein-Barr virus (EBV)-associated lymphomas have a virally mediated overexpression of PD-L1, also making them sensitive to PD-1 blockade. Therefore, PD-1 inhibitors are less effective in most r/r NHL than in r/r cHL. Further understanding of the biological features of NHL and immune checkpoint inhibitors (ICPi) combined therapy is the research focus in the future. In this review, we outlined the recent progress of ICPi in lymphoma originating from clinical studies.

摘要

经典型霍奇金淋巴瘤(cHL)已被证实存在9号染色体p24.1区域的普遍基因改变,该区域包含多个基因。9p24.1的扩增与RS细胞上 和 的表达增加相关,这促进了它们的免疫逃逸,随后使cHL对PD-1阻断敏感。几种PD-1抑制剂在复发/难治性(r/r)cHL中显示出显著疗效,总缓解率(ORR)为70%-90%,并已获得该适应症的批准。最近,越来越多的研究致力于探讨在疾病早期阶段以及与新药物或化疗联合使用时的PD-1阻断情况。与cHL不同,非霍奇金淋巴瘤(NHL)由众多具有高度生物学异质性的亚型组成。只有少数亚型被证明存在 基因改变,包括原发性纵隔B细胞淋巴瘤(PMBL)、具有弥漫性大B细胞淋巴瘤(DLBCL)和cHL之间中间特征的灰色地带淋巴瘤(GZL)、原发性中枢神经系统淋巴瘤(PCNSL)和原发性睾丸淋巴瘤(PTL)。爱泼斯坦-巴尔病毒(EBV)相关淋巴瘤具有病毒介导的PD-L1过表达,这也使它们对PD-1阻断敏感。因此,PD-1抑制剂在大多数r/r NHL中的疗效低于r/r cHL。进一步了解NHL的生物学特征以及免疫检查点抑制剂(ICPi)联合治疗是未来的研究重点。在本综述中,我们概述了源自临床研究的ICPi在淋巴瘤治疗中的最新进展。

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