以實驗室檢測評估免疫檢查點抑制劑治療的臨床反應

Evaluation of Clinical Responses to Immune Checkpoint Inhibitor Therapy by Laboratory Testing

譚焯瑩(Cheok-Ieng Tam)

指導教授 ： 李瑤玲 ； 郎斌

中山醫學大學/醫學科技學院/醫學檢驗暨生物技術學系碩士班/碩士(2018年)

摘要

免疫檢查點抑制劑療法自2011年美國食品藥品管理局(FDA)批准以來，已被廣泛應用於臨床上的治療。免疫檢查點抑制劑是透過活化免疫反應以達到治療惡性腫瘤的免疫療法。然而，許多病例報告指出，患者在接受此抑制劑的療程後出現免疫相關的不良反應，雖然大部分反應症狀輕微，但嚴重者可損害多個器官，甚至導致死亡。在本篇文獻回顧中，整合了近期對於免疫檢查點抑制劑療法的相關研究，以探討免疫檢查點抑制劑的治療機制與療程後引發免疫相關毒性反應的副作用;此外也介紹具有生物標誌潛力並用來預測患者臨床治療反應的檢驗項目，以提供醫師在選擇治療方案時的參考。

關鍵字

免疫檢查點抑制劑 ； 臨床反應 ； 毒性 ； 免疫相關不良反應 ； 生物標誌

並列摘要

Immune checkpoint inhibitor therapy has been popularly applied to clinical therapeutic use since approved by USFDA in 2011. It is a novel immunotherapeutic strategy to treat malignancies by activating the immune response. Yet immune-related adverse events have been reported in many cases when the patients received the immune checkpoint inhibitor for therapy. They can affect multiple organs, and even turn to be severe and lethal. In this review, we focus on the role of immune checkpoint inhibitor and the immune-related toxicity arisen in the course of treatment. We also discuss on the potential biomarkers that can be used to predict clinical responses as to provide a reference for a physician to make a decision on the therapeutic agents or the types of therapy used.

並列關鍵字

Immune checkpoint inhibitor ； clinical responses ； toxicity ； Immune-related adverse event ； biomarkers

參考文獻

Wan M, & Ming M. Nivolumab versus ipilimumab in the treatment of advanced melanoma: a critical appraisal. British Journal of Dermatology, 2018.

Batus M, Waheed S, Ruby C, Petersen L, Bines SD, & Kaufman HL. Optimal management of metastatic melanoma: current strategies and future directions. American journal of clinical dermatology 14(3), 179-194, 2013.

Park J, Kwon M, & Shin EC. Immune checkpoint inhibitors for cancer treatment. Arch Pharm Res 39(11), 1577-1587, 2016.

Schwartz R. A cell culture model for T lymphocyte clonal anergy. Science 248(4961), 1349-1356, 1990.

Salomon B, & Bluestone JA. Complexities of CD28/B7: CTLA-4 costimulatory pathways in autoimmunity and transplantation. Annual review of immunology 19(1), 225-252, 2001.