纳武利尤单抗治疗晚期胃癌临床研究进展

摘要: 全球范围内胃癌发病率最高的地区是东亚、南美和中美洲，在日本和韩国胃癌发病率居男性恶性肿瘤首位，在中国胃癌同样是导致癌症相关死亡的主要原因。目前晚期胃癌5年生存率为5%~20%，尚缺乏有效的治疗手段。免疫靶向治疗药物可逆转免疫检查点途径相关的肿瘤“免疫逃逸”，改变了晚期胃癌患者的治疗策略。以纳武利尤单抗（nivolumab）为代表的程序性死亡分子-1（programmed death-1，PD-1）抑制剂作为一种设计用于结合PD-1并阻断PD-1与其配体间相互作用的人源化IgG4单克隆抗体，是第一个在中国获批用于胃癌治疗的免疫检查点抑制剂，该药物突破了中国胃癌治疗“后线缺药”的僵局。本文围绕纳武利尤单抗的作用机制、临床试验、免疫相关不良反应、肿瘤快进展及假进展、生物标志物等方面最新研究进展进行综述。
- 纳武利尤单抗(nivolumab) /
- PD-1抑制剂 /
- 胃癌 /
- 消化道肿瘤
Abstract: The gastric cancer incidence rate is the highest in East Asia and South and Central America. The rates are particularly high in Japan and Korea, where gastric cancer is the main cause of death in men, and in China, where gastric cancer is a leading cause of cancer-related mortality. Presently, the 5-year survival rate of advanced gastric cancer is estimated to be approximately 5%-20%, and there is no effective treatment. Immunotargeting drugs can reverse the immune escape associated with the immune checkpoint pathway, thus changing the treatment strategy for patients with advanced gastric cancer. As a humanized IgG4 monoclonal antibody designed to bind programmed death-1 (PD-1) and block the interaction between PD-1 and its ligand, nivolumab was the first immunecheckpoint inhibitor approved for gastric cancer in China. This drug made a breakthrough in the"shortage of the posterior line"in the treatment of gastric cancer in China. In this paper, the mechanism of action, clinical trials, immune-related adverse events, hyper-progressive disease, pseudo-progression of the tumor, biomarkers, and other aspects of the latest research progress on nivolumab are reviewed.
- nivolumab /
- PD-1 inhibitor /
- gastric cancer /
- gastrointestinal tumor

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表 1 nivolumab治疗晚期胃癌的临床试验

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