晚期恶性胸膜间皮瘤免疫治疗进展

Advances in immunotherapy for pleural malignant mesothelioma

恶性胸膜间皮瘤(MPM)是一种与石棉暴露相关的恶性肿瘤,具有发病潜伏期长、早期诊断困难、晚期预后差等特点,化疗、放疗及抗血管生成治疗等多种治疗方式疗效不佳。近年来,免疫治疗成为肿瘤治疗新兴策略,多个临床试验均展示了免疫检查点抑制剂(ICIs)单药或联合方案在MPM一线、后续治疗的有效性;其中纳武利尤单抗(PD-1抑制剂)联合伊匹木单抗(CTLA-4抑制剂)成为各大指南推荐的首个应用于MPM的一线免疫治疗方案,是免疫治疗在MPM领域里程碑式进展。本文总结免疫治疗在晚期MPM中的现状,重点强调ICIs及靶向间皮素免疫治疗在MPM中的应用和疗效预测因子的进展。

Malignant pleural mesothelioma(MPM)is malignant cancer associated with asbestos exposure.MPM is characterized by a long incubation period,difficult diagnosis at the early phase and poor prognosis.Several kinds of therapy remain ineffective,including chemotherapy,radiotherapy,and anti-angiogenesis therapy.Recently,immunotherapy has become a promoting strategy in many cancer types,and many clinical trials show the anti-tumor efficacy of immune checkpoint inhibitors(ICIs)in advanced MPM.Among these ICIs,nivolumab(PD-1inhibitors)plus ipilimumab(CTLA-4 inhibitors)was approved as first-line treatment for advanced MPM patients,which marks a significant milestone for the treatment of this disease.In this review,we summarize the advances in immunotherapy for MPM,mainly focusing on the appliances of ICIs,mesothelin-targeted therapy,and the advances of predictive biomarkers.