Development of PD-1 and PD-L1 inhibitors as a form of cancer immunotherapy: a comprehensive review of registration trials and future considerations.

Development of PD-1 and PD-L1 inhibitors as a form of cancer immunotherapy: a comprehensive review of registration trials and future considerations.
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PD-1和PD-L1抑制剂作为癌症免疫疗法的一种形式的开发:对注册试验和未来考虑的全面综述。

DOI:
10.1186/s40425-018-0316-z
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发表时间:
2018-01-23
影响因子:
10.9
通讯作者:
Salgia R
Salgia R
中科院分区:
医学2区
文献类型:
--
作者:
Gong J;Chehrazi-Raffle A;Reddi S;Salgia R

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早期临床前证据提供了程序性细胞死亡1(PD-1)和程序性死亡配体1(PD-L1)阻断作为癌症免疫治疗的潜在形式的基本原理,因为PD-1/PD-L1轴的激活是肿瘤逃避宿主肿瘤抗原特异性T细胞免疫的机制。研究晚期实体瘤中靶向PD-1和PD-L1的几种人源化单克隆IgG 4抗体的早期研究为开发第一种PD-1抑制剂nivolumab和pembrolizumab铺平了道路,这些药物于2014年获得美国食品药品监督管理局(FDA)批准。FDA批准的这类药物的数量正在迅速增加,其治疗适应症涵盖了一系列恶性肿瘤。本综述的目的是强调迄今为止PD-1和PD-L1抑制剂在癌症治疗中的临床发展。特别是,我们专注于详细介绍FDA批准的抗PD-1和抗PD-L1治疗癌症的注册试验。随着PD-1/PD-L1抑制剂数量的持续增长,预测性生物标志物、耐药机制、超进展因子、治疗持续时间和进展后治疗、免疫相关毒性和临床试验设计是需要进一步考虑的关键概念,以优化这类免疫疗法的抗癌潜力。
Early preclinical evidence provided the rationale for programmed cell death 1 (PD-1) and programmed death ligand 1 (PD-L1) blockade as a potential form of cancer immunotherapy given that activation of the PD-1/PD-L1 axis putatively served as a mechanism for tumor evasion of host tumor antigen-specific T-cell immunity. Early-phase studies investigating several humanized monoclonal IgG4 antibodies targeting PD-1 and PD-L1 in advanced solid tumors paved way for the development of the first PD-1 inhibitors, nivolumab and pembrolizumab, approved by the Food and Drug Administration (FDA) in 2014. The number of FDA-approved agents of this class is rapidly enlarging with indications for treatment spanning across a spectrum of malignancies. The purpose of this review is to highlight the clinical development of PD-1 and PD-L1 inhibitors in cancer therapy to date. In particular, we focus on detailing the registration trials that have led to FDA-approved indications of anti-PD-1 and anti-PD-L1 therapies in cancer. As the number of PD-1/PD-L1 inhibitors continues to grow, predictive biomarkers, mechanisms of resistance, hyperprogressors, treatment duration and treatment beyond progression, immune-related toxicities, and clinical trial design are key concepts in need of further consideration to optimize the anticancer potential of this class of immunotherapy.
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