Department of Obstetrics and Gynecology, Korea University College of Medicine, 73 Koreadae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea.
Department of Obstetrics and Gynecology, Korea University College of Medicine, 148, Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea.
Int J Mol Sci. 2023 Jan 4;24(2):974. doi: 10.3390/ijms24020974.
Standard treatments for gynecological cancers include surgery, chemotherapy, and radiation therapy. However, there are limitations associated with the chemotherapeutic drugs used to treat advanced and recurrent gynecological cancers, and it is difficult to identify additional treatments. Therefore, immune checkpoint inhibitor (ICI) therapy products, including PD-1/PD-L1 inhibitors and CTLA-4 inhibitors, are in the spotlight as alternatives for the treatment of advanced gynecological cancers. Although the ICI monotherapy response rate in gynecological cancers is lower than that in melanoma or non-small cell lung cancer, the response rates are approximately 13-52%, 7-22%, and 4-17% for endometrial, ovarian, and cervical cancers, respectively. Several studies are being conducted to compare the outcomes of combining ICI therapy with chemotherapy, radiation therapy, and antiangiogenesis agents. Therefore, it is critical to determine the mechanism underlying ICI therapy-mediated anti-tumor activity and its application in gynecological cancers. Additionally, understanding the possible immune-related adverse events induced post-immunotherapy, as well as the appropriate management of diagnosis and treatment, are necessary to create a quality environment for immunotherapy in patients with gynecological cancers. Therefore, in this review, we summarize the ICI mechanisms, ICIs applied to gynecological cancers, and appropriate diagnosis and treatment of immune-related side effects to help gynecologists treat gynecological cancers using immunotherapy.
妇科癌症的标准治疗方法包括手术、化疗和放疗。然而，用于治疗晚期和复发性妇科癌症的化疗药物存在局限性，并且难以确定其他治疗方法。因此，免疫检查点抑制剂 (ICI) 治疗产品，包括 PD-1/PD-L1 抑制剂和 CTLA-4 抑制剂，作为治疗晚期妇科癌症的替代方法备受关注。尽管妇科癌症中 ICI 单药治疗的反应率低于黑色素瘤或非小细胞肺癌，但子宫内膜癌、卵巢癌和宫颈癌的反应率分别约为 13-52%、7-22%和 4-17%。正在进行几项研究来比较 ICI 治疗联合化疗、放疗和抗血管生成药物的结果。因此，确定 ICI 治疗介导的抗肿瘤活性的机制及其在妇科癌症中的应用至关重要。此外，了解免疫治疗后可能发生的免疫相关不良反应以及适当的诊断和治疗管理，对于为妇科癌症患者创造免疫治疗的优质环境是必要的。因此，在这篇综述中，我们总结了 ICI 机制、应用于妇科癌症的 ICI 以及免疫相关不良反应的适当诊断和治疗，以帮助妇科医生使用免疫疗法治疗妇科癌症。
