Prognostic Factors for Checkpoint Inhibitor Based Immunotherapy: An Update With New Evidences.

Prognostic Factors for Checkpoint Inhibitor Based Immunotherapy: An Update With New Evidences.
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DOI:
10.3389/fphar.2018.01050
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发表时间:
2018
影响因子:
5.6
通讯作者:
Xu H
Xu H
中科院分区:
医学2区
文献类型:
--
作者:
Yan X;Zhang S;Deng Y;Wang P;Hou Q;Xu H

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基于检查点抑制剂(CPI)的免疫疗法(即,抗CTLA-4/PD-1/PD-L1抗体)可以有效地延长晚期几种癌症类型患者的总生存期。然而,只有部分患者从这些治疗中获得客观反应,说明在疗效和药物不良反应方面存在很大的个体差异。通过对独立患者队列中一系列基于CPI的临床试验的观察,已经确定了多种临床和分子特征与CPI应答率的关联,包括微环境、癌细胞的基因组改变,甚至肠道微生物群。人们对这些预后因素是否以及如何用作精确免疫治疗中CPI最佳使用的生物标志物的问题产生了广泛的兴趣。本文综述了近年来通过多项临床试验和实验研究确定的候选预后因子,并对其作为肿瘤生物标志物在临床上应用的可能性和存在的问题进行了阐述。
Checkpoint inhibitor (CPI) based immunotherapy (i.e., anit-CTLA-4/PD-1/PD-L1 antibodies) can effectively prolong overall survival of patients across several cancer types at the advanced stage. However, only part of patients experience objective responses from such treatments, illustrating large individual differences in terms of both efficacy and adverse drug reactions. Through the observation on a series of CPI based clinical trials in independent patient cohorts, associations of multiple clinical and molecular characteristics with CPI response rate have been determined, including microenvironment, genomic alterations of the cancer cells, and even gut microbiota. A broad interest has been drawn to the question whether and how these prognostic factors can be used as biomarkers for optimal usage of CPIs in precision immunotherapy. Therefore, we reviewed the candidate prognostic factors identified by multiple trials and the experimental investigations, especially those reported in the recent 2 years, and described the possibilities and problems of them in routine clinical usage of cancer treatment as biomarkers.
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