PDF(Pubmed)
Abstract：
BACKGROUND: Sargramostim [recombinant human granulocyte-macrophage colony-stimulating factor (rhu GM-CSF)] was approved by US FDA in 1991 to accelerate bone marrow recovery in diverse settings of bone marrow failure and is designated on the list of FDA Essential Medicines, Medical Countermeasures, and Critical Inputs. Other important biological activities including accelerating tissue repair and modulating host immunity to infection and cancer via the innate and adaptive immune systems are reported in pre-clinical models but incompletely studied in humans.
OBJECTIVE: Assess safety and efficacy of sargramostim in cancer and other diverse experimental and clinical settings.
RESULTS: We systematically reviewed PubMed, Cochrane and TRIP databases for clinical data on sargramostim in cancer. In a variety of settings, sargramostim after exposure to bone marrow-suppressing agents accelerated hematologic recovery resulting in fewer infections, less therapy-related toxicity and sometimes improved survival. As an immune modulator, sargramostim also enhanced anti-cancer responses in solid cancers when combined with conventional therapies, for example with immune checkpoint inhibitors and monoclonal antibodies.
CONCLUSIONS: Sargramostim accelerates hematologic recovery in diverse clinical settings and enhances anti-cancer responses with a favorable safety profile. Uses other than in hematologic recovery are less-well studied; more data are needed on immune-enhancing benefits. We envision significantly expanded use of sargramostim in varied immune settings. Sargramostim has the potential to reverse the immune suppression associated with sepsis, trauma, acute respiratory distress syndrome (ARDS) and COVID-19. Further, sargramostim therapy has been promising in the adjuvant setting with vaccines and for anti-microbial-resistant infections and treating autoimmune pulmonary alveolar proteinosis and gastrointestinal, peripheral arterial and neuro-inflammatory diseases. It also may be useful as an adjuvant in anti-cancer immunotherapy.
OBJECTIVE: Assess safety and efficacy of sargramostim in cancer and other diverse experimental and clinical settings.
RESULTS: We systematically reviewed PubMed, Cochrane and TRIP databases for clinical data on sargramostim in cancer. In a variety of settings, sargramostim after exposure to bone marrow-suppressing agents accelerated hematologic recovery resulting in fewer infections, less therapy-related toxicity and sometimes improved survival. As an immune modulator, sargramostim also enhanced anti-cancer responses in solid cancers when combined with conventional therapies, for example with immune checkpoint inhibitors and monoclonal antibodies.
CONCLUSIONS: Sargramostim accelerates hematologic recovery in diverse clinical settings and enhances anti-cancer responses with a favorable safety profile. Uses other than in hematologic recovery are less-well studied; more data are needed on immune-enhancing benefits. We envision significantly expanded use of sargramostim in varied immune settings. Sargramostim has the potential to reverse the immune suppression associated with sepsis, trauma, acute respiratory distress syndrome (ARDS) and COVID-19. Further, sargramostim therapy has been promising in the adjuvant setting with vaccines and for anti-microbial-resistant infections and treating autoimmune pulmonary alveolar proteinosis and gastrointestinal, peripheral arterial and neuro-inflammatory diseases. It also may be useful as an adjuvant in anti-cancer immunotherapy.
摘要：
背景：Sargramostim[重组人粒细胞-巨噬细胞集落刺激因子（rhuGM-CSF）]于1991年获得美国FDA批准，可在各种骨髓衰竭情况下加速骨髓恢复，并被指定为FDA基本药物清单，医疗对策,和关键输入。在临床前模型中报道了其他重要的生物学活性，包括加速组织修复和通过先天和适应性免疫系统调节宿主对感染和癌症的免疫力，但在人类中尚未完全研究。
目的：评估sargamostim在癌症和其他不同实验和临床环境中的安全性和有效性。
结果：我们系统地回顾了PubMed，Cochrane和TRIP数据库，用于获取癌症中sargamostim的临床数据。在各种设置中，暴露于骨髓抑制剂后的sargramostim加速了血液学恢复，从而减少了感染，减少治疗相关的毒性，有时提高生存率。作为免疫调节剂，sargramostim也增强了抗癌反应在实体癌与常规治疗相结合，例如免疫检查点抑制剂和单克隆抗体。
结论：Sargramostim在不同的临床环境中加速血液学恢复，并增强抗癌反应，具有良好的安全性。除了血液学恢复以外的用途研究较少；需要更多关于免疫增强益处的数据。我们设想在各种免疫环境中显着扩大sargamostim的使用。Sargramostim具有逆转与脓毒症相关的免疫抑制的潜力，创伤,急性呼吸窘迫综合征（ARDS）和COVID-19。Further,sargramostim疗法在疫苗辅助设置和抗微生物耐药感染和治疗自身免疫性肺泡蛋白沉积症和胃肠道，外周动脉和神经炎症性疾病。它还可用作抗癌免疫疗法中的佐剂。
目的：评估sargamostim在癌症和其他不同实验和临床环境中的安全性和有效性。
结果：我们系统地回顾了PubMed，Cochrane和TRIP数据库，用于获取癌症中sargamostim的临床数据。在各种设置中，暴露于骨髓抑制剂后的sargramostim加速了血液学恢复，从而减少了感染，减少治疗相关的毒性，有时提高生存率。作为免疫调节剂，sargramostim也增强了抗癌反应在实体癌与常规治疗相结合，例如免疫检查点抑制剂和单克隆抗体。
结论：Sargramostim在不同的临床环境中加速血液学恢复，并增强抗癌反应，具有良好的安全性。除了血液学恢复以外的用途研究较少；需要更多关于免疫增强益处的数据。我们设想在各种免疫环境中显着扩大sargamostim的使用。Sargramostim具有逆转与脓毒症相关的免疫抑制的潜力，创伤,急性呼吸窘迫综合征（ARDS）和COVID-19。Further,sargramostim疗法在疫苗辅助设置和抗微生物耐药感染和治疗自身免疫性肺泡蛋白沉积症和胃肠道，外周动脉和神经炎症性疾病。它还可用作抗癌免疫疗法中的佐剂。
