-
摘要: 肺癌是全球癌症死亡的主要原因之一。其中非小细胞肺癌(non-small cell lung cancer,NSCLC)占所有肺癌病例的85%以上,尽管化疗及靶向治疗改善了患者临床疗效,但预后仍欠佳。免疫治疗的发展改变了NSCLC患者的治疗策略。纳武利尤单抗是一种针对程序性死亡受体-1(programmed cell death-1,PD-1)的完全人源化的IgG4单克隆抗体,是首个被批准用于晚期NSCLC治疗的免疫检查点抑制剂。纳武利尤单抗已经成为晚期NSCLC治疗的主要药物,但临床上尚缺乏预测疗效的生物标志物。本文针对纳武利尤单抗的作用机制、药代动力学、单药治疗、联合治疗、不良反应和潜在生物标志物的最新进展进行综述。Abstract: Lung cancer is the leading cause of cancer death and non-small cell lung cancer (NSCLC) accounts for >85% of all cancer deaths. Although chemotherapy and targeted therapy have improved clinical outcomes, prognosis remains poor. With the development of immunotherapy, the treatment strategy for patients with NSCLC has changed. Nivolumab, a human immunoglobulin G4 monoclonal antibody, was the first programmed cell death protein-1 (PD-1) inhibitor drug to be approved for treating advanced NSCLC and has become the primary drug for treating advanced NSCLC. However, there remains a lack of clinical biomarkers to predict the efficacy of nivolumab. In this review, we discuss the progress of therapeutic mechanisms, pharmacokinetics, pharmacology, clinical trials of monotherapy and combined therapy, adverse events, and predictive biomarkers.
-
Key words:
- nivolumab /
- non-small cell lung cancer /
- research progress
-
[1] Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018:Globocan estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2018, 68(6):394-424. doi: 10.3322/caac.21492 [2] Chen W, Zheng R, Baade PD, et al. Cancer statistics in china, 2015[J]. CA Cancer J Clin, 2016, 66(2):115-132. doi: 10.3322/caac.21338 [3] Jing W, Li M, Zhang Y, et al. PD-1/PD-l1 blockades in non-small-cell lung cancer therapy[J]. Onco Targets Ther, 2016, 9:489-502. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=3ab77b75431edb76684092883d8a3a2e [4] Keating GM. Nivolumab:A review in advanced nonsquamous nonsmall cell lung cancer[J]. Drugs, 2016, 76(9):969-978. doi: 10.1007/s40265-016-0589-9 [5] Wang L, Zhao D, Qin K, et al. Effect and biomarker of nivolumab for non-small cell lung cancer[J]. Biomed Pharmacother, 2019, 117:109-199. http://cn.bing.com/academic/profile?id=678b276afa4a8c265db139950cdcfee9&encoded=0&v=paper_preview&mkt=zh-cn [6] Berger KN, Pu JJ. PD-1 pathway and its clinical application:A 20year journey after discovery of the complete human pd-1 gene[J]. Gene, 2018, 638:20-25. doi: 10.1016/j.gene.2017.09.050 [7] Woo S-R, Turnis ME, Goldberg MV, et al. Immune inhibitory molecules LAG-3 and PD-1 synergistically regulate T-cell function to promote tumoral immune escape[J]. Cancer Res, 2012, 72(4):917-927. doi: 10.1158/0008-5472.CAN-11-1620 [8] Patsoukis N, Li L, Sari D, et al. PD-1 increases PTEN phosphatase activity while decreasing PTEN protein stability by inhibiting casein kinase 2[J]. Mol Cell Biol, 2013, 33(16):3091-3098. doi: 10.1128/MCB.00319-13 [9] Hofmeyer KA, Jeon H, Zang X. The PD-1/PD-l1(b7-h1) pathway in chronic infection-induced cytotoxic T lymphocyte exhaustion[J]. J Biomed Biotechnol, 2011, 2011:451694. http://cn.bing.com/academic/profile?id=4ac225c54a1335bc8a26c3ced1540c80&encoded=0&v=paper_preview&mkt=zh-cn [10] Wang C, Thudium KB, Han M, et al. In vitro characterization of the anti-PD-1 antibody nivolumab, bms-936558, and in vivo toxicology in non-human primates[J]. Cancer Immunol Res, 2014, 2(9):846-856. doi: 10.1158/2326-6066.CIR-14-0040 [11] Rizvi NA, Mazières J, Planchard D, et al. Activity and safety of nivolumab, an anti-PD-1 immune checkpoint inhibitor, for patients with advanced, refractory squamous non-small cell lung cancer (checkmate 063):A phase 2, single-arm trial[J]. Lancet Oncol, 2015, 16(3):257-265. doi: 10.1016/S1470-2045(15)70054-9 [12] Wu YL, Lu S, Cheng Y, et al. nivolumab versus docetaxel in a predominantly chinese patient population with previously treated advanced NSCLC:Checkmate 078 randomized phaseⅢ clinical trial[J]. J Thorac Oncol, 2019, 14(5):867-875. doi: 10.1016/j.jtho.2019.01.006 [13] Socinski M, Bondarenko I, Karaseva N, et al. Weekly nab-paclitaxel in combination with carboplatin versus solvent-based paclitaxel plus carboplatin as first-line therapy in patients with advanced nonsmall cell lung cancer:Final results of a phaseⅢ trial[J]. J Clin Oncol, 2012, 30(17):2055-2062. doi: 10.1200/JCO.2011.39.5848 [14] Gettinger SN, Horn L, Gandhi L, et al. Overall survival and long-term safety of nivolumab (anti-programmed death 1 antibody, bms-936558, ono-4538) in patients with previously treated advanced non-small cell lung cancer[J].J Clin Oncol, 2015, 33(18):2004-2012. doi: 10.1200/JCO.2014.58.3708 [15] Gettinger S, Horn L, Jackman D, et al. Five-year follow-up of nivolumab in previously treated advanced non-small cell lung cancer:Results from the CA209-003 study[J]. J Clin Oncol, 2018, 36(17):1675-1684. doi: 10.1200/JCO.2017.77.0412 [16] Lee JS, Lee KH, Cho EK, et al. Nivolumab in advanced non-small cell lung cancer patients who failed prior platinum-based chemotherapy[J]. Lung cancer, 2018, 122:234-242. doi: 10.1016/j.lungcan.2018.05.023 [17] Brahmer J, Reckamp KL, Baas P, et al. Nivolumab versus docetaxel in advanced squamous cell non-small cell lung cancer[J]. N Engl J Med, 2015, 373(2):123-135. doi: 10.1056/NEJMoa1504627 [18] Borghaei H, Paz-Ares L, Horn L, et al. Nivolumab versus docetaxel in advanced nonsquamous non-small cell lung cancer[J]. N Engl J Med, 2015, 373(17):1627-1639. doi: 10.1056/NEJMoa1507643 [19] Sundar R, Cho BC, Brahmer JR, et al. Nivolumab in NSCLC:Latest evidence and clinical potential[J]. Ther Adv Med Oncol, 2015, 7(2):85-96. doi: 10.1177/1758834014567470 [20] Juergens RA, Mariano C, Jolivet J, et al. Real-world benefit of nivolumab in a canadian non-small cell lung cancer cohort[J]. Curr Oncol, 2018, 25(6):384-392. http://cn.bing.com/academic/profile?id=7f82da339589492670e92e8bc3ba48d1&encoded=0&v=paper_preview&mkt=zh-cn [21] Horn L, Spigel DR, Vokes EE, et al. Nivolumab versus docetaxel in previously treated patients with advanced non-small cell lung cancer:Two-year outcomes from two randomized, open-label, phase Ⅲ trials (checkmate 017 and checkmate 057)[J]. J Clin Oncol, 2017, 35(35):3924-3933. doi: 10.1200/JCO.2017.74.3062 [22] Vokes EE, Ready N, Felip E, et al. Nivolumab versus docetaxel in previously treated advanced non-small cell lung cancer (checkmate 017 and checkmate 057):3-year update and outcomes in patients with liver metastases[J]. Ann Oncol, 2018, 29(4):959-965. doi: 10.1093/annonc/mdy041 [23] Carbone DP, Reck M, Paz-Ares L, et al. First-line nivolumab in stage Ⅳ or recurrent non-small cell lung cancer[J]. N Engl J Med, 2017, 376(25):2415-2426. doi: 10.1056/NEJMoa1613493 [24] Kanda S, Goto K, Shiraishi H, et al. Safety and efficacy of nivolumab and standard chemotherapy drug combination in patients with advanced non-small cell lung cancer:A four arms phaseⅠb study[J]. Ann Oncol, 2016, 27(12):2242-2250. doi: 10.1093/annonc/mdw416 [25] Rizvi NA, Hellmann MD, Brahmer JR, et al. Nivolumab in combination with platinum-based doublet chemotherapy for first-line treatment of advanced non-small cell lung cancer[J]. J Clin Oncol, 2016, 34(25):2969-2979. doi: 10.1200/JCO.2016.66.9861 [26] Hellmann MD, Rizvi NA, Goldman JW, et al. Nivolumab plus ipilimumab as first-line treatment for advanced non-small-cell lung cancer (checkmate 012):Results of an open-label, phase 1, multicohort study[J]. Lancet Oncol, 2017, 18(1):31-41. doi: 10.1016/S1470-2045(16)30624-6 [27] Ready N, Hellmann MD, Awad MM, et al. First-line nivolumab plus ipilimumab in advanced non-small cell lung cancer (checkmate 568):Outcomes by programmed death ligand 1 and tumor mutational burden as biomarkers[J]. J Clin Oncol, 2019, 37(12):992-1000. doi: 10.1200/JCO.18.01042 [28] Hellmann MD, Paz-Ares L, Caro RB, et al. Nivolumab plus ipilimumab in advanced non-small cell lung cancer[J]. N Engl J Med, 2019, 381(21):2020-2031. doi: 10.1056/NEJMoa1910231 [29] Forde PM, Chaft JE, Smith KN, et al. Neoadjuvant PD-1 blockade in resectable lung cancer[J]. N Engl J Med, 2018, 378(21):1976-1986. doi: 10.1056/NEJMoa1716078 [30] Fujimoto D, Morimoto T, Ito J, et al. A pilot trial of nivolumab treatment for advanced non-small cell lung cancer patients with mild idiopathic interstitial pneumonia[J]. Lung cancer, 2017, 111:1-5. doi: 10.1016/j.lungcan.2017.06.008 [31] Johnson DB, Balko JM, Compton ML, et al. Fulminant myocarditis with combination immune checkpoint blockade[J]. N Engl J Med, 2016, 375(18):1749-1755. doi: 10.1056/NEJMoa1609214 [32] Arrieta O, Montes-Servín E, Hernandez-Martinez J-M, et al. Expression of PD-1/PD-l1 and PD-l2 in peripheral T-cells from non-small cell lung cancer patients[J]. Oncotarget, 2017, 8(60):101994-102005. doi: 10.18632/oncotarget.22025 [33] Gettinger S, Rizvi NA, Chow LQ, et al. Nivolumab monotherapy for first-line treatment of advanced non-small cell lung cancer[J]. J Clin Oncol, 2016, 34(25):2980-2987. doi: 10.1200/JCO.2016.66.9929 [34] Hellmann MD, Ciuleanu TE, Pluzanski A, et al. Nivolumab plus ipilimumab in lung cancer with a high tumor mutational burden[J]. N Engl J Med, 2018, 378(22):2093-2104. doi: 10.1056/NEJMoa1801946 [35] Vanderwalde A, Spetzler D, Xiao N, et al. Microsatellite instability status determined by next-generation sequencing and compared with pd-l1 and tumor mutational burden in 11, 348 patients[J]. Cancer Med, 2018, 7(3):746-756. doi: 10.1002/cam4.1372 [36] Yoshimura K, Inoue Y, Mori K, et al. Distinct prognostic roles and heterogeneity of TTF1 copy number and TTF1 protein expression in non-small cell lung cancer[J].Genes Chromosomes Cancer, 2017, 56(7):570-581. doi: 10.1002/gcc.22461 [37] Taube JM, Klein A, Brahmer JR, et al. Association of PD-1, PD-1 ligands, and other features of the tumor immune microenvironment with response to anti-PD-1 therapy[J]. Clin Cancer Res, 2014, 20(19):5064-5074. doi: 10.1158/1078-0432.CCR-13-3271 [38] Miller BC, Sen DR, Al Abosy R, et al. Subsets of exhausted cd8+ T cells differentially mediate tumor control and respond to checkpoint blockade[J]. Nat Immunol, 2019, 20(3):326-336. doi: 10.1038/s41590-019-0312-6 [39] Diem S, Schmid S, Krapf M, et al. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as prognostic markers in patients with non-small cell lung cancer (NSCLC) treated with nivolumab[J]. Lung cancer, 2017, 111:176-181. doi: 10.1016/j.lungcan.2017.07.024 [40] Taniguchi Y, Tamiya A, Isa SI, et al. Predictive factors for poor progression-free survival in patients with non-small cell lung cancer treated with nivolumab[J]. Anticancer Res, 2017, 37(10):5857-5862. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=4a6767d1427ccc13e50a4da697819b0d
点击查看大图
计量
- 文章访问数: 128
- HTML全文浏览量: 3
- PDF下载量: 8
- 被引次数: 0