Is autoimmunity the Achilles' heel of cancer immunotherapy?
Is autoimmunity the Achilles' heel of cancer immunotherapy?
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DOI：
10.1038/nm.4321
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发表时间：
2017-05-01
期刊：
影响因子：
82.9
通讯作者：
Bluestone, Jeffrey A.
中科院分区：
文献类型：
--
作者：
June, Carl H.;Warshauer, Jeremy T.;Bluestone, Jeffrey A.
免疫肿瘤学作为转移性癌症的第一个广泛成功的策略的出现将要求临床医生将这一新的医学支柱与化疗，放疗和靶向小分子化合物相结合。同样重要的是了解免疫疗法的局限性和毒性。免疫疗法最初被认为是一种毒性相对较低的癌症治疗方法，比其他可用的治疗方法-当然，当与这些相比。然而，随着免疫疗法的使用变得越来越普遍，特别是作为一线和二线治疗，免疫毒性和自身免疫正在成为免疫疗法的阿喀琉斯之踵。在这个角度来看，我们讨论的证据表明，免疫毒性的发生是好兆头的病人，并描述机制，可能与诱导自身免疫。然后，我们探讨了限制免疫毒性的方法，并讨论了减少免疫毒性所需的研究和报告的未来方向。
The emergence of immuno-oncology as the first broadly successful strategy for metastatic cancer will require clinicians to integrate this new pillar of medicine with chemotherapy, radiation, and targeted small-molecule compounds. Of equal importance is gaining an understanding of the limitations and toxicities of immunotherapy. Immunotherapy was initially perceived to be a relatively less toxic approach to cancer treatment than other available therapies-and surely it is, when compared to those. However, as the use of immunotherapy becomes more common, especially as first-and second-line treatments, immunotoxicity and autoimmunity are emerging as the Achilles' heel of immunotherapy. In this Perspective, we discuss evidence that the occurrence of immunotoxicity bodes well for the patient, and describe mechanisms that might be related to the induction of autoimmunity. We then explore approaches to limit immunotoxicity, and discuss the future directions of research and reporting that are needed to diminish it.