The use of Toll-like receptor-7 agonist in the treatment of basal cell carcinoma: an overview
The use of Toll-like receptor-7 agonist in the treatment of basal cell carcinoma: an overview
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DOI：
10.1046/j.0366-077x.2003.05626.x
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发表时间：
2003-11-01
影响因子：
10.3
通讯作者：
Sterry, W
中科院分区：
文献类型：
--
作者：
Stockfleth, E;Trefzer, U;Sterry, W
基底细胞癌（BCC）是非黑色素瘤皮肤癌（NMSC）的一种亚型，在世界范围内发病率不断上升。目前，肿瘤切除和组织学控制是标准的治疗方法。然而，在许多国家，高发病率引起了对BCC管理所造成的经济负担的关注。咪喹莫特是一类新型免疫反应调节剂（IRM）的成员，它通过toll样受体(TLR)-7起作用。虽然确切的作用方式尚不清楚，但建议诱导不同细胞因子如白细胞介素(IL)-1、IL-6、IL-12、干扰素(IFN)- α和肿瘤坏死因子(TNF)- α的表达，刺激或增强先天免疫系统和细胞介导的免疫反应。临床前研究表明，这种TLR-7激动剂在治疗人类癌症前期和肿瘤方面具有潜力。尽管最合适的给药方案正在III期研究中得到确认，但许多II期试验已经证明了咪喹莫特治疗基底细胞癌的有效性。5%咪喹莫特乳膏主要用于浅表基底细胞癌的治疗似乎是一种有效且耐受性良好的治疗选择。
Basal cell carcinoma (BCC) is a subtype of nonmelanoma skin cancer (NMSC), with an increasing incidence worldwide. Currently, excision of the tumour with histological control is the standard therapy. However, high incidence rates have led to concern about the economic burden imposed by BCC management in many countries. Imiquimod is a member of a novel class of immune response modifiers (IRM), which works by using the toll-like receptor (TLR)-7. Although the exact mode of action is so far unknown, it is suggested to induce the expression of different cytokines like interleukin (IL)-1, IL-6, IL-12, interferon (IFN)-alpha and tumour necrosis factor (TNF)-alpha, which stimulate or enhance both the innate immune system and the cell-mediated immune response. Preclinical studies have indicated the potential of this TLR-7 agonist for the treatment of precancers and tumours in humans. A number of Phase II trials have demonstrated the efficacy of imiquimod for the treatment of BCC, although the most appropriate dosing regimen is being confirmed in Phase III studies. Imiquimod 5% cream for the treatment of mainly superficial BCC appears to be an effective and well-tolerated treatment option.