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Target Oncol. 2024 Jan;19(1):115-123. doi: 10.1007/s11523-023-01026-9. Epub 2024 Jan 18.
Tremelimumab (tremelimumab-actl; Imjudo) is a monoclonal antibody and immune checkpoint inhibitor (ICI) that blocks cytotoxic T lymphocyte-associated antigen-4 (CTLA-4). A single, priming dose of intravenous tremelimumab is used in combination with durvalumab, an ICI that blocks programmed cell-death ligand 1, in a regimen known as STRIDE (Single Tremelimumab Regular Interval Durvalumab). STRIDE is approved for the treatment of adults with unresectable hepatocellular carcinoma (HCC) in the USA and Japan and for the first-line treatment of adults with advanced or unresectable HCC in Europe. In the phase III HIMALAYA trial, STRIDE significantly improved overall survival (OS) compared with sorafenib in adults with unresectable HCC and no prior systemic therapy. A higher proportion of STRIDE versus sorafenib recipients had an objective response to treatment. The OS benefit associated with STRIDE was sustained with 4 years' follow-up. STRIDE had a manageable safety profile that differed from that of sorafenib. Grade 3 or 4 treatment-related adverse events occurred in a lower proportion of STRIDE versus sorafenib recipients. Based on the available evidence, tremelimumab used as part of the STRIDE regimen is a valuable first-line agent that expands the treatment options available to patients with advanced or unresectable HCC.
替西木单抗(tremelimumab-actl;Imjudo)是一种单克隆抗体和免疫检查点抑制剂(ICI),可阻断细胞毒性 T 淋巴细胞相关抗原-4(CTLA-4)。在 STRIDE(单替西木单抗定期间隔度伐鲁单抗)方案中,使用单次静脉注射替西木单抗与阻断程序性细胞死亡配体 1 的 ICI 度伐鲁单抗联合使用。STRIDE 在美国和日本获批用于治疗不可切除肝细胞癌(HCC)成人患者,在欧洲则获批用于治疗不可切除或晚期 HCC 成人患者的一线治疗。在 III 期 HIMALAYA 试验中,与索拉非尼相比,STRIDE 可显著改善不可切除 HCC 且无既往系统治疗的成人患者的总生存期(OS)。与索拉非尼相比,更多的 STRIDE 治疗者对治疗有客观反应。STRIDE 的 OS 获益在 4 年随访时得以维持。STRIDE 的安全性特征可管理,与索拉非尼不同。STRIDE 治疗者发生 3 级或 4 级治疗相关不良事件的比例低于索拉非尼治疗者。基于现有证据,替西木单抗作为 STRIDE 方案的一部分,是一种有价值的一线药物,为晚期或不可切除 HCC 患者提供了更多的治疗选择。
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