- 期刊
Atezolizumab：治療非小細胞肺癌的第一個一號配體抑制劑
Atezolizumab: Program Death-1 Receptor Ligand Inhibitor
摘要
免疫檢查點（immune check point）調節的發現，已經為癌症治療開立另一新契機。 2014年Ipilimumab成為台灣第一個上市的免疫療法藥物，之後陸續有著其他相同機轉藥物被引進台灣，成為標準癌症療法的另一選擇。Atezolizumab於2017年7月在台灣上市，已經被證實其對非小細胞肺癌第二線的治療角色。Atezolizumab是一個選擇性、人形化、IgG1抗體，結合癌細胞表面的PD-L1（計畫死亡受體一號）。PD-1 receptor是屬於B7-CD28家族的成員之一，具有兩個已知的配體，計畫死亡受體一號配體與二號配體（PD-L1與PD-L2）。當PD-L1或PD-L2與PD-1結合，T細胞的功能就會變得遲鈍，而這個現象常被癌細胞運用來逃過「腫瘤浸潤淋巴球」（tumor-infiltrating lymphocytes）的破壞。Atezolizumab即是透過此機轉達到控制癌症的效果。Atezolizumab可採口服或是靜脈注射給藥，最常見的副作用包括疲倦、噁心、食慾降低。免疫相關的副作用發生率小於1%，其中8%的病人因為這些副作用而停藥。
並列摘要
The discovery of immune modulation by immune checkpoints has led cancer treatment to a new era. In 2014, Ipilimumab became the first immune checkpoint inhibitor approved in Taiwan. Later, several other agents of the same category were introduced into Taiwan and they became one of the standard cancer therapies. Atezolizumab was approved by Taiwan Food and Drug Administration in July 2017 and has played a role since in the treatment of non-small cell lung cancer as one of the second-line choices. It is a selective, humanized, IgG1 antibody, which binds to the PD-L1 proteins on the surface of tumor cells. The PD-1 receptor is in the B7 (CD28) family, which has been known to react to two ligands, PD-L1 and PD-L2. When PD-L1 or PDL2 binds to the PD-1 receptor, the function of T lymphocytes becomes blunted. This mechanism is used by tumor cells to evade the destruction by tumor-infiltrating lymphocytes. Atezolizumab could prevent this evading mechanism from occurring. It is administered through intravenous infusion. The most common adverse effects are fatigue, nausea, and decrease in appetite. The immune-related adverse effects occur in less than 1% of patients and 8% of patients interrupted their treatment because of the side effects.