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癌症治疗背景下免疫检查点抑制剂综述。

Review of the Immune Checkpoint Inhibitors in the Context of Cancer Treatment.

作者信息

Alturki Norah A

机构信息

Clinical Laboratory Science Department, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia.

出版信息

J Clin Med. 2023 Jun 27;12(13):4301. doi: 10.3390/jcm12134301.

Abstract

Checkpoint proteins are an integral part of the immune system and are used by the tumor cells to evade immune response, which helps them grow uncontrollably. By blocking these proteins, immune checkpoint inhibitors can restore the capability of the immune system to attack cancer cells and stop their growth. These findings are backed by adequate clinical trial data and presently, several FDA-approved immune checkpoint inhibitors exist in the market for treating various types of cancers, including melanoma, hepatocellular, endometrial, lung, kidney and others. Their mode of action is inhibition by targeting the checkpoint proteins CTLA-4, PD-1, PD-L1, etc. They can be used alone as well as in amalgamation with other cancer treatments, like surgery, radiation or chemotherapy. Since these drugs target only specific immune system proteins, their side effects are reduced in comparison with the traditional chemotherapy drugs, but may still cause a few affects like fatigue, skin rashes, and fever. In rare cases, these inhibitors are known to have caused more serious side effects, such as cardiotoxicity, and inflammation in the intestines or lungs. Herein, we provide an overview of these inhibitors and their role as biomarkers, immune-related adverse outcomes and clinical studies in the treatment of various cancers, as well as present some future perspectives.

摘要

检查点蛋白是免疫系统不可或缺的一部分,肿瘤细胞利用它们来逃避免疫反应,从而使其能够不受控制地生长。通过阻断这些蛋白,免疫检查点抑制剂可以恢复免疫系统攻击癌细胞并阻止其生长的能力。这些发现有充分的临床试验数据支持,目前市场上有几种经美国食品药品监督管理局(FDA)批准的免疫检查点抑制剂用于治疗各种类型的癌症,包括黑色素瘤、肝细胞癌、子宫内膜癌、肺癌、肾癌等。它们的作用方式是通过靶向检查点蛋白CTLA-4、PD-1、PD-L1等来进行抑制。它们既可以单独使用,也可以与其他癌症治疗方法(如手术、放疗或化疗)联合使用。由于这些药物仅靶向特定的免疫系统蛋白,与传统化疗药物相比,它们的副作用有所减少,但仍可能引起一些影响,如疲劳、皮疹和发烧。在极少数情况下,已知这些抑制剂会引起更严重的副作用,如心脏毒性以及肠道或肺部炎症。在此,我们概述了这些抑制剂及其作为生物标志物的作用、免疫相关不良后果以及在各种癌症治疗中的临床研究,并提出了一些未来展望。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63f1/10342855/ba5925075be2/jcm-12-04301-g001.jpg

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