实用医学杂志 ›› 2024, Vol. 40 ›› Issue (2): 272-277.doi: 10.3969/j.issn.1006-5725.2024.02.025

• 综述 • 上一篇    下一篇

免疫检查点抑制剂治疗实体瘤的标志性成果

张雨峤1,梅伟健2()   

  1. 1. 兰州大学第一临床医学院 (兰州 730000 )
    2. 中山大学肿瘤防治中心结直肠科 (广州 510060 )
  • 收稿日期:2023-09-19 出版日期:2024-01-25 发布日期:2024-03-06
  • 通讯作者: 梅伟健 E-mail:meiwj@sysucc.org.cn
  • 基金资助:
    国家自然科学基金项目(82073159)

Landmark Achievements in Treating Solid Tumors with Immune Checkpoint Inhibitors

Yuqiao ZHANG1,Weijian MEI2()   

  1. The First Clinical Medical School,Lanzhou University,Lanzhou 730000,China.
  • Received:2023-09-19 Online:2024-01-25 Published:2024-03-06
  • Contact: Weijian MEI E-mail:meiwj@sysucc.org.cn

摘要:

肿瘤转移是实体瘤患者死亡的主要原因。细胞毒性化疗药物和靶向癌基因和肿瘤重要病理生理过程的靶向药物一过性诱导肿瘤退缩,但不能显著延长患者生存时间。从2011年第一个免疫检查点抑制剂(ICIs)伊匹木单抗上市以来,上市的ICIs药物已经包括CTLA-4、PD-1、PD-L1和LAG3特异性抗体四大类,在20多种实体瘤获得适应症。ICIs作为一种免疫疗法为实体瘤治疗带来革命性进步,从三方面改变了实体瘤临床实践:(1)部分晚期患者长期生存,甚至“临床治愈”。(2)依据特定标志物而不是病理类型的非特异性治疗策略,使罕见肿瘤患者及时获得治疗机会。(3)ICIs新辅助治疗策略使部分患者免于大范围的毁损性手术,从而保全器官功能和提高患者生活质量。本文通过总结多项临床研究结果,详细分析上述三项标志性成果的循证医学证据,为ICIs药物的创新性提供详实的依据。

关键词: 免疫检查点抑制剂, 长期生存, 非特异性治疗, 保全器官功能

Abstract:

Tumor metastasis is a primary cause of death among solid tumor patients. Interventions such as chemotherapy with cytotoxic drugs and other targeted therapies focusing on specific genes or tumorigenesis can induce tumor shrinkage in most cases. However, these interventions do not substantially prolong the lives of patients. In recent years, immunotherapy has made significant breakthroughs in treating solid tumors with the introduction of immune checkpoint inhibitors (ICIs), following the clinical use of Ipilimumab, the first anti?tumor drug with ICIs initially approved in 2011. Currently, four types of ICIs including CTLA?4, PD?1, PD?L1, and LAG3 have been clinically applied and have demonstrated specificity towards more than 20 types of solid tumors. The significance of ICIs lies in their superiority to conventional drugs in three aspects: (1) They can prolong the survival of late?stage patients and even achieve “clinical cure”; (2)They allow patients with rare tumors access a pan?tumor treatment based on specific biomarkers; and (3)They can free a majority of patients from invasive surgical approaches to preserve organ functions, thereby improving patient’s quality of life. This article provides a summary of multiple clinical research projects and explores the clinical evidence derived from the notable achievements related to the three advantages.

Key words: immune checkpoint inhibitors, long?term survival, tissue?agnostic therapy, organ?sparing

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