通过近年来对肿瘤免疫调节机制的研究,发现在实体肿瘤及淋巴瘤中,肿瘤微环境对保护肿瘤细胞不被机体免疫系统识别和杀伤起到了非常重要的作用。其中程序性死亡分子1(programmed death 1,PD-1)及其配体PD-L1(PD-1 ligand,PD-L1)是肿瘤微...通过近年来对肿瘤免疫调节机制的研究,发现在实体肿瘤及淋巴瘤中,肿瘤微环境对保护肿瘤细胞不被机体免疫系统识别和杀伤起到了非常重要的作用。其中程序性死亡分子1(programmed death 1,PD-1)及其配体PD-L1(PD-1 ligand,PD-L1)是肿瘤微环境中重要的负性免疫调节信号,抑制了肿瘤特异性CD8+T细胞的免疫活性,介导了肿瘤细胞的免疫逃逸[1]。PD-1/PD-L1轴被认为是肿瘤细胞逃避免疫监视的重要机制,成为一个重要的免疫检查点[2]。PD1与其配体PD-L1的作用已被广泛研究,近几年在血液系统恶性肿瘤中也进行了新的临床和临床前试验,本文对PD-1/PD-L1检查点在急性白血病中的研究进展及其治疗前景等方面的医学文献进行综述,为临床实验提供新思路。展开更多
Aim:Immune checkpoint inhibitors(ICIs)are proven to be an effective way to treat the disease of hematologic malignancies.But there is still plenty of uncertainty about the effectiveness of ICIs on hepatocellular carci...Aim:Immune checkpoint inhibitors(ICIs)are proven to be an effective way to treat the disease of hematologic malignancies.But there is still plenty of uncertainty about the effectiveness of ICIs on hepatocellular carcinoma.The Meta-analysis was conducted to evaluate the efficacy and safety of ICIs treatment in patients with HCC.Methods:Four electronic databases,including PubMed,Embase,Cochrane database,and ClinicalTrials.gov,were systematically retrieved for relevant observational studies published before November 1,2018.The objective response rate(ORR)and adverse events were analyzed.Meta and Metafor Packages in R were utilized to accomplish meta proportion analysis.Results:A total of 462 patients from 7 studies were included in this meta-analysis.The pooled estimated ORR of ICIs was 19.8%(95%CI 16.4%to 23.7%).No substantial heterogeneity was observed among studies(Q=2.0427,P=0.92,I 2=0.0%).The common adverse events on any grade were saw in increased AST(22.7%,95%CI 13.8%to 35.2%),fatigue(20.9%,95%CI 10.9%to 36.3%),rash(18.5%,95%CI 8.9%to 34.4%)and pruritus(17.3%,95%CI 13.5%to 21.8%).Increased AST(9.9%,95%CI 4.4%to 21.0%)and increased ALT(5.8%,95%CI 3.7%to 8.9%)were the most common adverse events on grade greater than 3.Conclusion:Although ICIs treatment has a certain efficacy on liver cancer,it also causes some adverse events which should be noticed by clinicians.展开更多
文摘通过近年来对肿瘤免疫调节机制的研究,发现在实体肿瘤及淋巴瘤中,肿瘤微环境对保护肿瘤细胞不被机体免疫系统识别和杀伤起到了非常重要的作用。其中程序性死亡分子1(programmed death 1,PD-1)及其配体PD-L1(PD-1 ligand,PD-L1)是肿瘤微环境中重要的负性免疫调节信号,抑制了肿瘤特异性CD8+T细胞的免疫活性,介导了肿瘤细胞的免疫逃逸[1]。PD-1/PD-L1轴被认为是肿瘤细胞逃避免疫监视的重要机制,成为一个重要的免疫检查点[2]。PD1与其配体PD-L1的作用已被广泛研究,近几年在血液系统恶性肿瘤中也进行了新的临床和临床前试验,本文对PD-1/PD-L1检查点在急性白血病中的研究进展及其治疗前景等方面的医学文献进行综述,为临床实验提供新思路。
基金This work was supported by National Key Basic Research Program of China(No.2015CB554000).
文摘Aim:Immune checkpoint inhibitors(ICIs)are proven to be an effective way to treat the disease of hematologic malignancies.But there is still plenty of uncertainty about the effectiveness of ICIs on hepatocellular carcinoma.The Meta-analysis was conducted to evaluate the efficacy and safety of ICIs treatment in patients with HCC.Methods:Four electronic databases,including PubMed,Embase,Cochrane database,and ClinicalTrials.gov,were systematically retrieved for relevant observational studies published before November 1,2018.The objective response rate(ORR)and adverse events were analyzed.Meta and Metafor Packages in R were utilized to accomplish meta proportion analysis.Results:A total of 462 patients from 7 studies were included in this meta-analysis.The pooled estimated ORR of ICIs was 19.8%(95%CI 16.4%to 23.7%).No substantial heterogeneity was observed among studies(Q=2.0427,P=0.92,I 2=0.0%).The common adverse events on any grade were saw in increased AST(22.7%,95%CI 13.8%to 35.2%),fatigue(20.9%,95%CI 10.9%to 36.3%),rash(18.5%,95%CI 8.9%to 34.4%)and pruritus(17.3%,95%CI 13.5%to 21.8%).Increased AST(9.9%,95%CI 4.4%to 21.0%)and increased ALT(5.8%,95%CI 3.7%to 8.9%)were the most common adverse events on grade greater than 3.Conclusion:Although ICIs treatment has a certain efficacy on liver cancer,it also causes some adverse events which should be noticed by clinicians.
