CLIN CANCER RES:PD-1阻断时机对联合免疫治疗疗效至关重要

2017-10-29 MedSci MedSci原创

靶向PD-1和CTLA-4的特异性抗体在治疗实体肿瘤时疗效显着。对于免疫检查点抑制剂单药治疗后复发的患者,联合免疫治疗可能成为一种理想的治疗方式。但是如何有效地将免疫检查点抑制和靶向T细胞共刺激受体的药物如OX40等进行结合仍然是个问题。CLIN CANCER RES近期发表了一篇文章,对这一问题进行了研究。

靶向PD-1和CTLA-4的特异性抗体在治疗实体肿瘤时疗效显着。对于免疫检查点抑制剂单药治疗后复发的患者,联合免疫治疗可能成为一种理想的治疗方式。但是如何有效地将免疫检查点抑制和靶向T细胞共刺激受体的药物如OX40等进行结合仍然是个问题。CLIN CANCER RES近期发表了一篇文章,对这一问题进行了研究。

作者使用抗PD-1复发,原位移植MMTV-PyMT肿瘤模型研究抗OX40抗体联合抗PD-1治疗的抗肿瘤效果。由于PD-1通常在T细胞活化后发挥其免疫作用,作者分别使用同步联合治疗和抗OX40序贯抗PD-1治疗两种不同方式对老鼠进行治疗。研究结果表明,与单独进行抗OX40治疗相比,同步进行额外的抗PD-1治疗效果可以显着降低。接受同步治疗的老鼠Ⅰ型和Ⅱ型血清因子增加并且显着增强T细胞抑制性受体或疲劳标志物CTLA-4和TIM-3表达。在第13天,联合治疗可以增加肿瘤内CD4+T细胞增殖,但是在第19天,与未接受治疗的老鼠相比,CD4+和CD8+T细胞增殖显着下降。抗OX40后序贯抗PD-1治疗可以显着增强治疗效果。对于MMTV-PyMT肿瘤,序贯治疗同时依赖CD4+和CD8+T细胞,在约30%的治疗动物中出现肿瘤完全退化。

文章最后认为,该研究结果表明联合免疫治疗时间点对最终治疗效果具有重要作用,推荐在进一步的临床试验中进行序贯免疫治疗。

原始出处:
David J.Messenheimer,Shawn M.Jensen,et al.Timing of PD-1 Blockade Is Critical to Effective Combination Immunotherapy with Anti-OX40.CLIN CANCER RES.October 2017 doi:10.1158/1078-0432.CCR-16-2677

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    2018-07-12 wshxjq
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    2017-10-31 gdsun
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    2017-10-29 清风拂面

    谢谢分享.学习了

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PD-1抗体是最成功的癌症免疫疗法药物之一,目前已被FDA批准用于包括黑色素瘤、非小细胞肺癌、肾细胞癌、经典型霍奇金淋巴瘤、头颈癌、膀胱癌、结直肠癌等在内的多个适应症。然而,这类免疫检查点抑制剂也有它的局限。目前,仅约有15%-25%的患者能够响应这类药物。

JAMA Neurol:PD-1单抗治疗相关神经系统并发症及其处置方法

研究发现,神经系统不良反应与抗PD-1治疗相关,表现出多种表型以及频繁的神经并发症,尽管上述并发症较为罕见,但PD-1单抗疗法的并发症频率显著高于其他肿瘤疗法,且发作时间不可预知,进展迅速且致命。研究认为出现PD-1治疗相关的神经系统并发症后应立即终止治疗,必要时采取免疫应激治疗