ICIS

ICIs
  • 文章类型: Journal Article
    肝细胞癌(HCC)是最常见的癌症之一,也是全球第三大死亡原因。手术,经动脉化疗栓塞术(TACE),全身治疗,局部消融治疗,放射治疗,以及索拉非尼等药物的靶向药物治疗。然而,肝癌的肿瘤微环境具有很强的免疫抑制作用。因此,肝癌的新疗法仍然是必要的。免疫检查点分子,如程序性死亡-1(PD-1),程序性死亡配体1(PD-L1),和细胞毒性T淋巴细胞抗原-4(CTLA-4),伴随着高水平的免疫抑制细胞因子,诱导T细胞抑制,是肝癌免疫逃逸的关键机制。最近,基于免疫检查点抑制剂(ICIs)的免疫疗法作为单一疗法或与酪氨酸激酶抑制剂联合使用,抗血管生成药物,化疗药物,和局部疗法在肝癌的治疗中提供了巨大的希望。在这次审查中,我们讨论了ICIs联合靶向药物(靶向免疫联合)和其他靶向免疫联合治疗方案的最新进展,用于治疗晚期HCC(aHCC)或不可切除的HCC(uHCC)。并对未来前景进行展望。回顾的文献跨越过去五年,包括使用关键词确定的研究,如“肝细胞癌,免疫检查点抑制剂,“靶向治疗”,联合治疗,“和”免疫疗法“。
    Hepatocellular carcinoma (HCC) is one of the most common cancers and the third leading cause of death worldwide. surgery, transarterial chemoembolization (TACE), systemic therapy, local ablation therapy, radiotherapy, and targeted drug therapy with agents such as sorafenib. However, the tumor microenvironment of liver cancer has a strong immunosuppressive effect. Therefore, new treatments for liver cancer are still necessary. Immune checkpoint molecules, such as programmed death-1 (PD-1), programmed death-ligand 1 (PD-L1), and cytotoxic T lymphocyte antigen-4 (CTLA-4), along with high levels of immunosuppressive cytokines, induce T cell inhibition and are key mechanisms of immune escape in HCC. Recently, immunotherapy based on immune checkpoint inhibitors (ICIs) as monotherapy or in combination with tyrosine kinase inhibitors, anti-angiogenesis drugs, chemotherapy agents, and topical therapies has offered great promise in the treatment of liver cancer. In this review, we discuss the latest advances in ICIs combined with targeted drugs (targeted-immune combination) and other targeted-immune combination regimens for the treatment of patients with advanced HCC (aHCC) or unresectable HCC (uHCC), and provide an outlook on future prospects. The literature reviewed spans the last five years and includes studies identified using keywords such as \"hepatocellular carcinoma,\" \"immune checkpoint inhibitors,\" \"targeted therapy,\" \"combination therapy,\" and \"immunotherapy\".
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  • 文章类型: Journal Article
    针对不同系统肿瘤的免疫检查点抑制剂(ICI)疗法由于其特异性高、副作用小的治疗特点,取得了显著的成果,改变了肿瘤治疗的现状。免疫检查点程序性死亡1/程序性细胞死亡配体1(PD-1/PD-L1)轴在肿瘤细胞的免疫逃逸中起着至关重要的作用。因此,已成为肿瘤免疫治疗的关键靶点。因此,为了完善对PD-1/PD-L1轴潜在调节因素的研究,为了理解和说明肿瘤ICI治疗机制,是一个重要的目标。此外,ncRNA已被证实可以调节肿瘤免疫微环境中的PD-1/PD-L1轴,从而调节肿瘤发生和发展。ncRNA可以通过调节PD-L1表达来改善或降低ICI治疗的功效。本文旨在探讨ncRNA在ICI治疗中调节PD-1/PD-L1轴的作用机制。为不同系统的肿瘤提供更有效的免疫疗法。
    Immune checkpoint inhibitor (ICI) therapies for tumors of different systems have attained significant achievements and have changed the current situation of tumor treatment due to their therapeutic characteristics of high specificity and low side effects. The immune checkpoint Programmed death 1/Programmed cell death-Ligand 1 (PD-1/PD-L1) axis exerts a vital role in the immune escape of tumor cells. As a result, it has become a key target for tumor immunotherapy. Therefore, to perfect research into potential regulatory factors for the PD-1/PD-L1 axis, in order to understand and illustrate tumor ICI therapy mechanisms, is a significant goal. Moreover, ncRNA has been verified to regulate the PD-1/PD-L1 axis in the tumor immune microenvironment to regulate tumor genesis and development. ncRNAs can improve or decrease the efficacy of ICI therapy by modulating PD-L1 expression. This review aimed to investigate the mechanisms of action of ncRNA in regulating the PD-1/PD-L1 axis in ICI therapy, to provide more efficient immunotherapy for tumors of different systems.
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  • 文章类型: Journal Article
    为了确定进口免疫检查点抑制剂(ICIs)的成本效益,如阿特珠单抗和durvalumab,和国内ICIs像serplulimab和adebrelimab,联合化疗治疗中国广泛期小细胞肺癌(ES-SCLC)。
    使用21天的周期长度和20年的时间范围,建立了Markov模型,比较了5种一线ICI加化疗与单纯化疗的临床和经济结果,以及彼此对抗,从中国医疗体系的角度来看。通过结合CAPSTONE-1试验的结果和已发表的网络荟萃分析来估计转移概率。从多个来源收集了成本和健康国家公用事业。成本和有效性结果都以每年5%的速度打折。主要模型输出是增量成本效益比(ICER)。进行了一系列敏感性分析,以评估模型的稳健性。
    在基本情况分析中,在化疗中增加一线ICIs导致ICER的范围从$80,425.31/QALY到$812,415.46/QALY,超过了该模型设定的支付意愿阈值。当比较这些一线免疫化疗策略时,serplulimab联合化疗的QALYs最高,为1.51286,第二低的成本为60,519.52美元,是最具成本效益的策略.我们的亚组水平分析得出的结果与基本情况分析一致。敏感性分析结果证实了模型的有效性和可靠性。
    在中国,与单纯化疗相比,一线ICIs+化疗的组合不被认为具有成本效益.然而,当这些一线免疫化疗策略相互比较时,一线serplulimab联合化疗在成本效益方面始终显示出优越性.降低每4.5mg/kgserplulimab的成本将是使一线serplulimab加化疗更容易获得和具有成本效益的现实步骤。
    UNASSIGNED: To determine the cost-effectiveness of imported immune checkpoint inhibitors (ICIs) such as atezolizumab and durvalumab, and domestic ICIs like serplulimab and adebrelimab, in combination with chemotherapy for extensive-stage small cell lung cancer (ES-SCLC) in China.
    UNASSIGNED: Using a 21-day cycle length and a 20-year time horizon, a Markov model was established to compare the clinical and economic outcomes of five first-line ICIs plus chemotherapy versus chemotherapy alone, as well as against each other, from the perspective of the Chinese healthcare system. Transition probabilities were estimated by combining the results of the CAPSTONE-1 trial and a published network meta-analysis. Cost and health state utilities were collected from multiple sources. Both cost and effectiveness outcomes were discounted at a rate of 5% annually. The primary model output was incremental cost-effectiveness ratios (ICERs). A series of sensitivity analyses were preformed to assess the robustness of the model.
    UNASSIGNED: In the base-case analysis, the addition of first-line ICIs to chemotherapy resulted in the ICERs ranged from $80,425.31/QALY to $812,415.46/QALY, which exceeded the willing-to-pay threshold set for the model. When comparing these first-line immunochemotherapy strategies, serplulimab plus chemotherapy had the highest QALYs of 1.51286 and the second lowest costs of $60,519.52, making it is the most cost-effective strategy. Our subgroup-level analysis yielded results that are consistent with the base-case analysis. The sensitivity analysis results confirmed the validity and reliability of the model.
    UNASSIGNED: In China, the combination of fist-line ICIs plus chemotherapy were not considered cost-effective when compared to chemotherapy alone. However, when these fist-line immunochemotherapy strategies were compared with each other, first-line serplulimab plus chemotherapy consistently demonstrated superiority in terms of cost-effectiveness. Reducing the cost of serplulimab per 4.5 mg/kg would be a realistic step towards making first-line serplulimab plus chemotherapy more accessible and cost-effective.
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  • 文章类型: Meta-Analysis
    评估用于恶性肿瘤患者的抗癌药物免疫检查点抑制剂(ICIs)的心血管安全性。
    检索了自建立以来已完成的4个临床研究数据库,并统计计算各指标的比值比和95%置信区间.
    纳入了62项随机对照试验和对照试验。在单一药物治疗ICIs组中,各级心脑血管疾病的总体风险高于安慰剂/化疗组.特别是在所有级别的心肌炎和3级以上,与正常对照组相比,除了心包病变,其他指标无明显副作用。
    单独使用抗肿瘤ICIs可能会增加癌症患者心血管副作用的风险,所以我们需要加强监测,识别和管理,并及时干预管理ICI引起的不良事件。
    UNASSIGNED: To evaluate the cardiovascular safety of anticancer drug immune checkpoint inhibitors (ICIs) used in patients with malignant tumors.
    UNASSIGNED: Four clinical research databases that have been completed since their establishment were searched, and the odds ratios and 95% confidence intervals of each indicator were statistically calculated.
    UNASSIGNED: 62 randomized controlled trial and controlled trials were included. In single drug treatment ICIs group, the overall risk of cardio cerebral Vascular disease at all levels was higher than that in the placebo/chemotherapy group. Especially in all grades of Myocarditis and above grade 3 compared with normal controls, except for pericardial lesions, other indicators have no obvious side effects.
    UNASSIGNED: Single drug use of an anti-tumor ICIs may increase cardiovascular side effects risk in cancer patients, so we need to strengthen monitoring, identification and management, and timely intervention to manage ICI induced adverse events.
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  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    严重急性呼吸道综合征冠状病毒2(SARS-CoV-2)感染引发2019年冠状病毒病(COVID-19),主要针对呼吸道。SARS-CoV-2感染,特别是严重的COVID-19,与对该病毒的免疫反应失调有关,包括被称为细胞因子风暴的过度炎症反应,淋巴细胞和NK细胞功能障碍被称为免疫细胞衰竭。阴性免疫检查点如PD-1和CTLA-4的过表达在SARS-CoV-2感染后免疫细胞的功能障碍中起着相当大的作用。有人建议封锁这些检查站,通过促进针对该病毒的有效免疫反应,改善COVID-19患者的临床预后。在当前的审查中,我们概述了检查点抑制剂在诱导针对SARS-CoV-2的强效免疫应答和改善重症COVID-19患者临床结局方面的潜力.
    Infection with severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) triggers coronavirus disease 2019 (COVID-19), which predominantly targets the respiratory tract. SARS-CoV-2 infection, especially severe COVID-19, is associated with dysregulated immune responses against the virus, including exaggerated inflammatory responses known as the cytokine storm, together with lymphocyte and NK cell dysfunction known as immune cell exhaustion. Overexpression of negative immune checkpoints such as PD-1 and CTLA-4 plays a considerable role in the dysfunction of immune cells upon SARS-CoV-2 infection. Blockade of these checkpoints has been suggested to improve the clinical outcome of COVID-19 patients by promoting potent immune responses against the virus. In the current review, we provide an overview of the potential of checkpoint inhibitors to induce potent immune responses against SARS-CoV-2 and improving the clinical outcome of severe COVID-19 patients.
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  • 文章类型: Journal Article
    在过去的二十年里,免疫疗法越来越被认为是大多数癌症的一线治疗方法.一种这样的治疗是免疫检查点阻断(ICB),在临床试验中已证明对各种实体瘤有希望的结果。单克隆抗体(mAb)目前可用作免疫检查点抑制剂(ICI)。这些ICI针对特定的免疫检查点,包括细胞毒性T淋巴细胞相关抗原-4(CTLA-4)和程序性细胞死亡蛋白1(PD-1)。临床试验结果强烈支持这种免疫治疗方法的可行性。然而,相当比例的癌症患者对治疗产生耐药性或耐受性,由于抵消宿主免疫反应的肿瘤免疫逃避机制。因此,大量的研究重点是确定额外的ICIs或协同抑制性受体,以增强抗PD-1,抗程序性细胞死亡配体1(抗PD-L1)的有效性,和抗CTLA-4治疗。最近,已经确定了几种免疫检查点分子靶标,例如具有Ig和ITIM结构域的T细胞免疫受体(TIGIT),含粘蛋白结构域-3(TIM-3),淋巴细胞活化基因-3(LAG-3),T细胞激活的V域免疫球蛋白抑制剂(VISTA),B和T淋巴细胞衰减因子(BTLA),和信号调节蛋白α(SIRPα)。靶向这些分子的功能性mAb正在开发中。CTLA-4,PD-1/PD-L1和其他最近发现的具有不同结构的免疫检查点蛋白处于研究的前沿。这篇综述讨论了这些结构,以及靶向这些免疫检查点分子的单克隆抗体的临床进展及其潜在应用。
    Over the past two decades, immunotherapies have increasingly been considered as first-line treatments for most cancers. One such treatment is immune checkpoint blockade (ICB), which has demonstrated promising results against various solid tumors in clinical trials. Monoclonal antibodies (mAbs) are currently available as immune checkpoint inhibitors (ICIs). These ICIs target specific immune checkpoints, including cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) and programmed cell death protein 1 (PD-1). Clinical trial results strongly support the feasibility of this immunotherapeutic approach. However, a substantial proportion of patients with cancer develop resistance or tolerance to treatment, owing to tumor immune evasion mechanisms that counteract the host immune response. Consequently, substantial research focus has been aimed at identifying additional ICIs or synergistic inhibitory receptors to enhance the effectiveness of anti-PD-1, anti-programmed cell death ligand 1 (anti-PD-L1), and anti-CTLA-4 treatments. Recently, several immune checkpoint molecular targets have been identified, such as T cell immunoreceptor with Ig and ITIM domains (TIGIT), mucin domain containing-3 (TIM-3), lymphocyte activation gene-3 (LAG-3), V-domain immunoglobulin suppressor of T cell activation (VISTA), B and T lymphocyte attenuator (BTLA), and signal-regulatory protein α (SIRPα). Functional mAbs targeting these molecules are under development. CTLA-4, PD-1/PD-L1, and other recently discovered immune checkpoint proteins with distinct structures are at the forefront of research. This review discusses these structures, as well as clinical progress in mAbs targeting these immune checkpoint molecules and their potential applications.
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  • 文章类型: Journal Article
    背景:晚期不可切除的胃癌(GC)患者以前曾单独使用化疗作为一线治疗。然而,随着食品和药物管理局(FDA)2022批准程序性细胞死亡蛋白1(PD-1)抑制剂联合化疗作为晚期不可切除的GC的第一个治疗方法,患者显著受益。然而,巨大的成本和潜在的不利影响需要精确的患者选择.近年来,深度学习(DL)的出现彻底改变了医学领域,特别是在预测肿瘤治疗反应。我们的研究利用DL分析病理图像,旨在预测一线PD-1联合化疗对晚期GC的反应。
    方法:在这项多中心回顾性分析中,从四个医疗中心的晚期GC患者收集苏木精和伊红(H&E)染色的载玻片。在综合一线PD-1免疫疗法联合化疗后,根据iRECIST1.1标准评估治疗反应。在集成方法中采用三个DL模型来创建免疫检查点抑制剂反应评分(ICIsRS)作为源自全幻灯片图像(WSI)的新型组织病理学生物标志物。
    结果:分析了264例晚期GC患者313个WSI的148,181个贴片,集成模型表现出优异的预测精度,导致ICIsNet的创建。该模型在四个测试数据集上表现出稳健的性能,AUC值分别为0.92、0.95、0.96和1。盒子情节,从ICIsRS建造,揭示了良好反应和不良反应之间的统计学显著差异(所有p值<=0.001)。
    结论:ICIsRS,来自WSI的DL衍生生物标志物,有效预测晚期GC患者对PD-1联合化疗的反应,为个性化治疗计划提供了一种新的方法,并允许根据患者的独特反应情况制定更个性化和潜在有效的治疗策略。
    BACKGROUND: Advanced unresectable gastric cancer (GC) patients were previously treated with chemotherapy alone as the first-line therapy. However, with the Food and Drug Administration\'s (FDA) 2022 approval of programmed cell death protein 1 (PD-1) inhibitor combined with chemotherapy as the first-li ne treatment for advanced unresectable GC, patients have significantly benefited. However, the significant costs and potential adverse effects necessitate precise patient selection. In recent years, the advent of deep learning (DL) has revolutionized the medical field, particularly in predicting tumor treatment responses. Our study utilizes DL to analyze pathological images, aiming to predict first-line PD-1 combined chemotherapy response for advanced-stage GC.
    METHODS: In this multicenter retrospective analysis, Hematoxylin and Eosin (H&E)-stained slides were collected from advanced GC patients across four medical centers. Treatment response was evaluated according to iRECIST 1.1 criteria after a comprehensive first-line PD-1 immunotherapy combined with chemotherapy. Three DL models were employed in an ensemble approach to create the immune checkpoint inhibitors Response Score (ICIsRS) as a novel histopathological biomarker derived from Whole Slide Images (WSIs).
    RESULTS: Analyzing 148,181 patches from 313 WSIs of 264 advanced GC patients, the ensemble model exhibited superior predictive accuracy, leading to the creation of ICIsNet. The model demonstrated robust performance across four testing datasets, achieving AUC values of 0.92, 0.95, 0.96, and 1 respectively. The boxplot, constructed from the ICIsRS, reveals statistically significant disparities between the well response and poor response (all p-values < = 0.001).
    CONCLUSIONS: ICIsRS, a DL-derived biomarker from WSIs, effectively predicts advanced GC patients\' responses to PD-1 combined chemotherapy, offering a novel approach for personalized treatment planning and allowing for more individualized and potentially effective treatment strategies based on a patient\'s unique response situations.
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  • 文章类型: Journal Article
    不正常的癌细胞可以长成肿瘤,侵入周围组织,并通过淋巴或循环系统传播到身体的其他部位。白细胞介素,一类重要的信号蛋白,促进免疫系统内的细胞与细胞接触。一种称为lncRNAs的非编码RNA通过调节miRNA-mRNA的作用(白细胞介素)来介导其作用。由于它们在控制肿瘤生长和改变免疫系统对癌细胞的反应方面的双重功能,白细胞介素已被广泛研究有关癌症。了解白细胞介素之间的复杂关系,免疫系统,肿瘤微环境,以及影响miRNA-mRNA轴的白细胞介素信号通路的组成部分,包括lncRNAs,在癌症研究方面取得了显著进展。由于白细胞介素对免疫系统和癌症的发展和进展的显著和全面的影响,lncRNAs通过调节白细胞介素在癌症研究中发挥关键作用。它们对免疫系统调节的不同影响,肿瘤生长的鼓励,和肿瘤抑制使他们成为潜在癌症治疗和诊断的候选人。对白细胞介素和lncRNAs生物学之间关系的更深入的理解可能会导致更有效的免疫治疗策略和个体化的癌症治疗。
    The cancer cells that are not normal can grow into tumors, invade surrounding tissues, and travel to other parts of the body via the lymphatic or circulatory systems. Interleukins, a vital class of signaling proteins, facilitate cell-to-cell contact within the immune system. A type of non-coding RNA known as lncRNAs mediates its actions by regulating miRNA-mRNA roles (Interleukins). Because of their dual function in controlling the growth of tumors and altering the immune system\'s response to cancer cells, interleukins have been extensively studied concerning cancer. Understanding the complex relationships between interleukins, the immune system, the tumor microenvironment, and the components of interleukin signaling pathways that impact the miRNA-mRNA axis, including lncRNAs, has advanced significantly in cancer research. Due to the significant and all-encompassing influence of interleukins on the immune system and the development and advancement of cancers, lncRNAs play a crucial role in cancer research by modulating interleukins. Their diverse effects on immune system regulation, tumor growth encouragement, and tumor inhibition make them appealing candidates for potential cancer treatments and diagnostics. A deeper understanding of the relationship between the biology of interleukin and lncRNAs will likely result in more effective immunotherapy strategies and individualized cancer treatments.
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  • 文章类型: Journal Article
    免疫检查点抑制剂(ICIs)作为免疫疗法恢复T细胞功能和重新激活抗肿瘤免疫已显示出巨大的希望。美国食品和药物管理局(FDA)批准了第一个免疫检查点抑制剂,ipilimumab,2011年晚期黑色素瘤患者,显著提高生存率。随后,我们检测了其他免疫检查点靶向抗体.目前,七个ICIs,即ipilimumab(抗细胞毒性T淋巴细胞相关蛋白4[CTLA4]),pembrolizumab,纳武单抗(抗程序性细胞死亡蛋白1[PD-1]),阿替珠单抗,阿维鲁单抗,durvalumab,和cemiplimab(抗PD-L1),已被批准用于各种癌症类型。然而,靶向CTLA4或PD-1/程序性死亡-配体1(PD-L1)的抗体的疗效仍不理想.因此,正在进行的研究正在评估下一代ICI,如淋巴细胞活化基因-3(LAG3),T细胞免疫球蛋白和含粘蛋白结构域3(TIM3),和T细胞免疫球蛋白和ITIM结构域(TIGIT)。我们的综述提供了评估这些新型免疫检查点在癌症治疗中的临床试验的摘要。
    Immune checkpoint inhibitors (ICIs) have shown great promise as immunotherapy for restoring T cell function and reactivating anti-tumor immunity. The US Food and Drug Administration (FDA) approved the first immune checkpoint inhibitor, ipilimumab, in 2011 for advanced melanoma patients, leading to significant improvements in survival rates. Subsequently, other immune checkpoint-targeting antibodies were tested. Currently, seven ICIs, namely ipilimumab (anti-cytotoxic T lymphocyte-associated protein 4 [CTLA4]), pembrolizumab, nivolumab (anti-programmed cell death protein 1 [PD-1]), atezolizumab, avelumab, durvalumab, and cemiplimab (anti-PD-L1), have been approved for various cancer types. However, the efficacy of antibodies targeting CTLA4 or PD-1/programmed death-ligand 1 (PD-L1) remains suboptimal. Consequently, ongoing studies are evaluating the next generation of ICIs, such as lymphocyte activation gene-3 (LAG3), T cell immunoglobulin and mucin-domain containing 3 (TIM3), and T cell immunoglobulin and ITIM domain (TIGIT). Our review provides a summary of clinical trials evaluating these novel immune checkpoints in cancer treatment.
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