在双重CTLA-4和PD-1免疫疗法中,预防性TNF阻断将疗效与毒性脱离
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
概括
使用PD-1和CTLA-4阻断剂的联合免疫疗法对癌症治疗具有前景,但会引起严重的副作用. 与这些疗法同时使用TNF抑制剂可以降低毒性,同时保持或改善抗瘤功效.
科学领域:
- 免疫学
- 癌症学
- 药理学
背景情况:
- 联合PD- 1和CTLA- 4阻断对各种癌症有效,但会导致与免疫相关的重大不良事件.
- 在双重免疫治疗后患有大肠炎的患者中,瘤亡因子 (TNF) 升高.
研究的目的:
- 研究TNF抑制剂与PD- 1和CTLA- 4联合免疫疗法的有效性.
- 确定TNF抑制是否可以改善与免疫相关的不良事件而不会影响抗瘤作用.
主要方法:
- 用PD-1/ CTLA-4联合免疫疗法和TNF抑制剂治疗小鼠.
- 使用移植对宿主疾病 (GVHD) 和异种移植的人类结肠癌细胞的人性化小鼠模型.
- 评估大肠炎,肝炎和抗瘤功效.
主要成果:
- 与双重免疫疗法同时进行的TNF抑制可改善小鼠的结肠炎.
- 在添加TNF抑制剂时,抗瘤疗效保持或改善.
- 在人性化的GVHD模型中,预防性TNF阻塞降低了结肠炎和肝炎,同时保持了抗瘤控制.
结论:
- 与TNF抑制剂同时治疗是一种临床可行的策略,可减轻与联合免疫检查点阻塞相关的毒性.
- 这种方法有可能分离疗效和毒性,改善癌症免疫治疗患者的结果.
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