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抗细胞毒性T淋巴细胞相关抗原4(CTLA4)抗体易普利姆玛给药后的不良事件。

Adverse Events Following Administration of Anti-CTLA4 Antibody Ipilimumab.

作者信息

Karimi Amirali, Alilou Sanam, Mirzaei Hamid Reza

机构信息

School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Department of Medical Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Front Oncol. 2021 Mar 9;11:624780. doi: 10.3389/fonc.2021.624780. eCollection 2021.

Abstract

Ipilimumab, a monoclonal anti-CTLA4 antibody, paved the path for promising treatments, particularly in advanced forms of numerous cancers like melanoma. By blockading CTLA-4, ipilimumab can abolish the higher binding affinity of B7 for CTLA-4, setting CD28 free to act unlimited. This blockade can result in an amplified antitumor immune response, and thereby, boosting more effective tumor regression. However, this blockage can lead to diminished self-tolerance and yielding autoimmune complications. The current review aims to describe adverse events (AEs) following the administration of ipilimumab in different cancers as every benefit comes at a cost. We will also discuss AEs in two different categories, melanoma and non-melanoma, owing to the possible shining promises in treating non-melanoma cancers. As the melanoma settings are more studied than other cancers, it might even help predict the patterns related to the other types of cancers. This similarity also might help physicians to predict adverse events and correctly manage them in non-melanoma cancers using the extensive findings reported in the more-studied melanoma settings. Recognizing the adverse events is vital since most of the adverse events could be reverted while carefully implementing guidelines. Finally, we will also describe the observed effectiveness of ipilimumab in non-melanoma cancers. This effectiveness reveals the importance of understanding the profile of adverse events in this group, even though some have not received FDA approval yet. Further clinical trials and careful systematic reviews may be required to decipher the hidden aspects of therapies with ipilimumab and its related AEs.

摘要

伊匹单抗,一种单克隆抗CTLA4抗体,为有前景的治疗方法铺平了道路,特别是在多种癌症的晚期形式如黑色素瘤中。通过阻断CTLA-4,伊匹单抗可以消除B7对CTLA-4的更高结合亲和力,使CD28能够不受限制地发挥作用。这种阻断可导致抗肿瘤免疫反应增强,从而促进更有效的肿瘤消退。然而,这种阻断可能导致自身耐受性降低并产生自身免疫并发症。本综述旨在描述在不同癌症中使用伊匹单抗后的不良事件(AE),因为每项益处都有代价。由于在治疗非黑色素瘤癌症方面可能有光明前景,我们还将讨论黑色素瘤和非黑色素瘤这两类不同癌症中的不良事件。由于黑色素瘤的情况比其他癌症研究得更多,它甚至可能有助于预测与其他类型癌症相关的模式。这种相似性也可能有助于医生利用在研究较多的黑色素瘤病例中报告的广泛发现,预测非黑色素瘤癌症中的不良事件并正确处理它们。认识到不良事件至关重要,因为在仔细执行指南的情况下,大多数不良事件是可以逆转的。最后,我们还将描述伊匹单抗在非黑色素瘤癌症中观察到的疗效。这种疗效揭示了了解该组不良事件特征的重要性,尽管其中一些尚未获得美国食品药品监督管理局(FDA)的批准。可能需要进一步的临床试验和仔细的系统评价来解读伊匹单抗治疗及其相关不良事件的隐藏方面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d06/7985548/b05f0cb2f651/fonc-11-624780-g001.jpg

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