Ipilimumab: its potential in non-small cell lung cancer
Ipilimumab: its potential in non-small cell lung cancer
复制标题
DOI：
10.1177/1758834011431718
复制
发表时间：
2012-03-01
影响因子：
4.9
通讯作者：
Barlesi, Fabrice
中科院分区：
文献类型：
--
作者：
Tomasini, Pascale;Khobta, Nataliya;Barlesi, Fabrice
Ipilimumab 是一种全人源单克隆抗体，通过细胞毒性 T 淋巴细胞抗原 4 阻断来增强抗肿瘤免疫力。它已被美国食品和药物管理局批准用于治疗转移性黑色素瘤，并且正在研究用于治疗其他实体瘤，如肾细胞癌、前列腺癌和肺癌。这篇综述详细介绍了易普利姆玛 (ipilimumab) 在治疗非小细胞肺癌 (NSCLC) 方面的潜力。特别是，伊匹单抗在卡铂/紫杉醇化疗与同步或分期伊匹单抗相结合的一线 NSCLC II 期研究中显示出有希望的结果。分期 ipilimumab 组的中位免疫相关无进展生存期为 5.68 个月，而单独化疗组为 4.63 个月（风险比 [HR] = 0.68，p = 0.026）；同步 ipilimumab 组为 5.52 个月，而单独化疗组为 4.63 个月（HR = 0.77，p = 0.094）。主要不良事件与免疫相关，如垂体炎、小肠结肠炎、甲状腺功能亢进等。这些不良事件可以通过高剂量糖皮质激素得到改善，并且可能与肿瘤反应相关。 III 期研究正在进行中。未来的研究可能会调查伊匹单抗在早期肺癌治疗中的作用。还讨论了潜在的转化研究策略，以确定使用伊匹单抗治疗 NSCLC 患者的预后和预测生物标志物。
Ipilimumab is a fully human monoclonal antibody that enhances antitumor immunity by way of cytotoxic T-lymphocyte antigen 4 blockade. It has already been approved by the US Food and Drug Administration for the treatment of metastatic melanoma and is being investigated for treating other solid tumors such as renal cell, prostate and lung cancers. This review details the potential of ipilimumab in the management of non-small cell lung cancer (NSCLC). In particular, ipilimumab showed promising results in a first-line NSCLC phase II study combining carboplatin/paclitaxel chemotherapy with concurrent or phased ipilimumab. The median immune-related progression-free survival was 5.68 months for the phased ipilimumab arm versus 4.63 months for chemotherapy alone (hazard ratio [HR] = 0.68, p = 0.026) and 5.52 months for the concurrent ipilimumab arm versus 4.63 months for chemotherapy alone (HR = 0.77, p = 0.094). The main adverse events were immune related, such as hypophysitis, enterocolitis, and hyperthyroidism. These adverse events may be improved with high-dose glucocorticoids and may be correlated with tumor response. Phase III studies are ongoing. Future studies may investigate ipilimumab in the management of early stage lung cancer. Strategies for potential translational research studies are also discussed to identify prognostic and predictive biomarkers for the use of ipilimumab in the treatment of patients with NSCLC.