用于转移性割抗性前列腺癌的 pembrolizumab:试验和苦难
Alexander K Tsai1,2, Sana Kagalwalla1, Jenna Langer1
1Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota, Masonic Cancer Center, Minneapolis, MN, USA.
Expert opinion on biological therapy
|January 29, 2024
概括
布罗利祖马布 (一种编程死亡1阻断抗体) 对大多数转移性前列腺癌患者的结果没有改善. PD-L1表达不能预测反应,这凸显了对新型免疫治疗策略的需求.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 前列腺癌研究 研究前列腺癌
背景情况:
- 免疫疗法,特别是编程死亡1 (PD-1) 阻断布罗利祖马布等抗体,已经改变了癌症治疗.
- 它在前列腺癌中的应用正在出现,超越特定的遗传标记物到更广泛的患者群体.
研究的目的:
- 总结四个临床试验Pembrolizumab在转移性前列腺癌的第三期临床试验的发现.
- 审查PD-L1表达和分子缺陷在治疗反应中的作用.
- 讨论新兴的组合策略和前列腺癌免疫治疗的未来方向.
主要方法:
- 分析了来自四项关键的III期临床试验的数据:KEYNOTE-641,KEYNOTE-921,KEYNOTE-991和KEYLYNK-010.
- 作为预测生物标志物的编程死亡配体1 (PD-L1) 表达的审查.
- 评估pembrolizumab与化疗,下一代荷尔蒙药物 (NHA) 和多基 (ADP-ribose) 聚合酶抑制剂 (PARPi) 结合的疗效.
主要成果:
- 当添加到化疗,NHA或PARPi时, pembrolizumab对未经选择的转移性前列腺癌患者没有益处.
- 编程死亡连接体1 (PD-L1) 的阳性不能可靠地预测该患者群体对 pembrolizumab 的反应.
- 一小部分患者表现出益处,可能是由于罕见的遗传或分子变化.
结论:
- 目前基于pembrolizumab的治疗方案对大多数转移性前列腺癌患者是无效的.
- 新的组合策略和替代性免疫瘤学方法对于改善治疗结果至关重要.
- 未来的研究应该集中在识别预测生物标志物和开发超越PD-1/PD-L1抑制的更有效的免疫疗法.
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