内分泌瘤的免疫疗法:临床医生的观点
Anna Angelousi1, Ploutarchos Tzoulis2, Marina Tsoli3
11st Department of Internal Medicine, Unit of Endocrinology, Laikon Hospital, Athens, Greece.
Endocrine-related cancer
|January 18, 2024
概括
免疫疗法在大多数内分泌瘤中表现出有限的疗效,对上腺皮质癌和神经内分泌瘤的反应率有所变化. 对PD-L1和TMB等生物标志物的进一步研究对于预测治疗成功至关重要.
科学领域:
- 在瘤学瘤学.
- 内分泌学 在内分泌学.
- 免疫学 免疫学 免疫学
背景情况:
- 免疫疗法,特别是免疫检查点抑制剂 (ICI),已经改变了癌症治疗,但在内分泌瘤中应用有限.
- 常规疗法失败后,ICI通常用于晚期或耐药的内分泌恶性瘤.
研究的目的:
- 审查当前免疫疗法,特别是ICI在各种内分泌瘤中的疗效.
- 在内分泌癌症中确定免疫治疗反应的潜在预测生物标志物.
主要方法:
- 对评估ICI在上腺皮质癌,叶红色细胞瘤/上腺瘤,甲状腺癌和神经内分泌瘤中的研究进行系统审查.
- 分析应答率和讨论影响疗效的因素,包括瘤类型,突变负担和PD-L1表达.
主要成果:
- 在内分泌瘤中观察到的可变响应率:上腺皮质癌 (14-23%),上腺细胞瘤/上腺瘤 (9%),差异化甲状腺癌 (9%),髓性甲状腺癌 (低,除高TMB外),类甲状腺癌 (高TMB/PD-L1更好),副甲状腺癌 (有限),下垂体癌 (潜在有利),高级神经内分泌瘤 (15%).
- 结合ICI与氨酸激酶抑制剂的组合,在差异化甲状腺癌中显示出更高的疗效.
- 高瘤突变负担 (TMB) 和PD-L1表达似乎预测了形甲状腺癌的更好的反应.
结论:
- 用ICI进行免疫治疗在内分泌瘤中显示出有限但可变的疗效,需要进一步研究.
- 生物标志物,如编程死亡1/编程死亡连接体1 (PD-1/PD-L1) 和TMB,需要作为反应预测因素进行评估.
- 随机前性研究对于建立关于ICI在内分泌瘤学中的有效性和安全性的可靠数据至关重要.
关键词:
上腺瘤 上腺瘤侵袭性垂体瘤是一种瘤.厌塑性甲状腺癌是甲状腺癌.差异性甲状腺癌的癌症.免疫检查点抑制剂 免疫检查点抑制剂骨髓甲状腺癌是一种甲状腺癌.神经内分泌新生体的神经内分泌新生体副甲状腺癌 副甲状腺癌下垂体癌的癌症甲状腺癌是甲状腺癌.更多相关视频
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