予防的なTNF阻害は,CTLA-4とPD-1の両方の免疫療法における有効性と毒性を分離する
Elisabeth Perez-Ruiz1,2,3,4,5, Luna Minute1,2, Itziar Otano1,2
1Program of Immunology and Immunotherapy, Cima Universidad de Navarra, Pamplona, Spain.
Nature
|May 3, 2019
まとめ
PD- 1とCTLA- 4阻害剤を用いた併用免疫療法は,がん治療において有望であるが,重度の副作用を引き起こす. これらの治療法とTNF阻害剤の併用は,抗腫瘍効果を維持または改善しながら,毒性を減少させる可能性があります.
科学分野:
- 免疫学
- 腫瘍学
- 薬理学について
背景:
- PD- 1とCTLA- 4の結合阻害は様々な癌に対して有効ですが,免疫関連の重大な有害事象を引き起こします.
- 二重免疫療法後に大腸炎を患った患者では,腫瘍死滅因子 (TNF) が上昇する.
研究 の 目的:
- TNF阻害剤とPD- 1とCTLA- 4の併用免疫療法の有効性を調査する.
- 抗腫瘍効果を損なうことなく,TNF抑制が免疫関連の有害事象を改善できるかどうかを判断する.
主な方法:
- 併用PD- 1/ CTLA- 4免疫療法とTNF阻害剤によるマウスの治療
- 移植対宿主疾患 (GVHD) と異種移植されたヒト結腸がん細胞のヒト化したマウスモデルを使用した.
- 大腸炎,肝炎,抗腫瘍効果の評価
主要な成果:
- 二重免疫療法と併用したTNF阻害は,マウスの大腸炎を改善した.
- TNF阻害剤を追加すると,抗腫瘍効果は維持または改善された.
- ヒト化GVHDモデルにおける予防的なTNF阻害は,抗腫瘍制御を維持しながら大腸炎と肝炎を減少させた.
結論:
- TNF阻害剤との併用治療は,結合免疫チェックポイント阻害に関連した毒性を軽減するための臨床的に実現可能な戦略です.
- このアプローチは有効性と毒性を分離し,がん免疫療法における患者の結果を改善する可能性があります.
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