Zander Hilke, Müller-Egert Susanne, Zwiewka Michal, Groß Steffen, van Zandbergen Ger, Engelbergs Jörg
Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-56, 63225, Langen, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2020 Nov;63(11):1322-1330. doi: 10.1007/s00103-020-03221-9. Epub 2020 Oct 1.
In recent years, a breakthrough in tumor therapy was achieved with the development of checkpoint inhibitors. Checkpoint inhibitors activate the immune defense against tumors by overcoming the inhibitory effect of specific cell surface proteins acting as control points, the so-called checkpoints. This article provides an overview of the mode of action of approved checkpoint inhibitors and the status of current clinical development.The previously approved checkpoint inhibitors, monoclonal antibodies directed against the checkpoints CTLA‑4 and PD-1/PD-L1, are used in various tumor entities (including lung, kidney, and urothelial carcinoma; head and neck cancer; melanoma; and Hodgkin lymphoma). For the first time, long-term survival has been achieved in some of these patients with advanced tumors. Unfortunately, this efficacy can be observed only in a small proportion of the treated patients, depending on the tumor indication. Improved efficacy is envisioned by patient selection via predictive biomarkers and the development of combination therapies. Mandatory testing of the expression level of the predictive PD-L1 biomarker is already required in some indications to select patients with an enhanced benefit/risk relationship.
近年来,随着检查点抑制剂的发展,肿瘤治疗取得了突破。检查点抑制剂通过克服作为控制点的特定细胞表面蛋白(即所谓的检查点)的抑制作用,激活针对肿瘤的免疫防御。本文概述了已获批的检查点抑制剂的作用模式以及当前临床开发的状况。先前获批的检查点抑制剂,即针对检查点CTLA-4和PD-1/PD-L1的单克隆抗体,被用于多种肿瘤类型(包括肺癌、肾癌和尿路上皮癌;头颈癌;黑色素瘤;以及霍奇金淋巴瘤)。在一些患有晚期肿瘤的患者中首次实现了长期生存。不幸的是,根据肿瘤适应症的不同,这种疗效仅能在一小部分接受治疗的患者中观察到。通过预测性生物标志物进行患者选择以及开发联合疗法有望提高疗效。在某些适应症中,已经要求强制检测预测性PD-L1生物标志物的表达水平,以选择受益/风险关系更佳的患者。