5．進行期非小細胞肺癌における免疫チェックポイント阻害薬の可能性と課題
免疫チェックポイント阻害薬（immune checkpoint inhibitor：ICI）であるnivolumabおよびpembrolizumabは，新たな一次治療および二次治療以降の選択肢として，進行期非小細胞肺癌の薬物療法を大きく変えた．非小細胞肺癌に対するICIの使用においては，腫瘍細胞におけるprogrammed cell death ligand-1（PD-L1）発現割合検査を適切に実施することが求められる．さらに投与後に認められる効果・副作用の特徴を十分に理解し，免疫関連有害事象が発症した場合には，関係する診療科と適切に連携し管理を行うことが重要である．...
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| Published in | 日本内科学会雑誌 Vol. 106; no. 6; pp. 1117 - 1124 |
|---|---|
| Main Authors | , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本内科学会
10.06.2017
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0021-5384 1883-2083 |
| DOI | 10.2169/naika.106.1117 |
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| Abstract | 免疫チェックポイント阻害薬（immune checkpoint inhibitor：ICI）であるnivolumabおよびpembrolizumabは，新たな一次治療および二次治療以降の選択肢として，進行期非小細胞肺癌の薬物療法を大きく変えた．非小細胞肺癌に対するICIの使用においては，腫瘍細胞におけるprogrammed cell death ligand-1（PD-L1）発現割合検査を適切に実施することが求められる．さらに投与後に認められる効果・副作用の特徴を十分に理解し，免疫関連有害事象が発症した場合には，関係する診療科と適切に連携し管理を行うことが重要である． |
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| AbstractList | 免疫チェックポイント阻害薬（immune checkpoint inhibitor：ICI）であるnivolumabおよびpembrolizumabは，新たな一次治療および二次治療以降の選択肢として，進行期非小細胞肺癌の薬物療法を大きく変えた．非小細胞肺癌に対するICIの使用においては，腫瘍細胞におけるprogrammed cell death ligand-1（PD-L1）発現割合検査を適切に実施することが求められる．さらに投与後に認められる効果・副作用の特徴を十分に理解し，免疫関連有害事象が発症した場合には，関係する診療科と適切に連携し管理を行うことが重要である． |
| Author | 田中, 謙太郎 岡本, 勇 |
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| References | 5) Brahmer J, et al: Nivolumab versus Docetaxel in advanced squamous-cell non-small-cell lung cancer. N Engl J Med 373: 123-135, 2015. 6) Borghaei H, et al: Nivolumab versus Docetaxel in advanced nonsquamous non-small-cell lung cancer. N Engl J Med 373: 1627-1639, 2015. 4) Leach DR, et al: Enhancement of antitumor immunity by CTLA-4 blockade. Science 271: 1734-1736, 1996. 10) Chiou VL, Burotto M: Pseudoprogression and immune-related response in solid tumors. J Clin Oncol 33: 3541-3543, 2015. 17) Hirsch FR, et al: PD-L1 immunohistochemistry assays for lung cancer: results from phase 1 of the blueprint PD-L1 IHC assay comparison project. J Thorac Oncol 12: 208-222, 2017. 13) Hodi FS, et al: Immunologic and clinical effects of antibody blockade of cytotoxic T lymphocyte-associated antigen 4 in previously vaccinated cancer patients. Proc Natl Acad Sci U S A 105: 3005-3010, 2008. 19) Singh H, et al: FDA subset analysis of the safety of nivolumab in elderly patients with advanced cancers. Abstract 10010, ASCO Annual Meeting, 2016. 11) Hodi FS, et al: Evaluation of immune-related response criteria and RECIST v1.1 in patients with advanced melanoma treated with pembrolizumab. J Clin Oncol 34: 1510-1517, 2016. 2) Schreiber RD, et al: Cancer immunoediting: integrating immunity's roles in cancer suppression and promotion. Science 331: 1565-1570, 2011. 3) Ishida Y, et al: Induced expression of PD-1, a novel member of the immunoglobulin gene superfamily, upon programmed cell death. EMBO J 11: 3887-3895, 1992. 16) Gibney GT, et al: Predictive biomarkers for checkpoint inhibitor-based immunotherapy. Lancet Oncol 17: e542-e551, 2016. 9) Nishio M, et al: Multicentre phase II study of nivolumab in Japanese patients with advanced or recurrent non-squamous non-small cell lung cancer. ESMO Open 1: e000108, 2016. 12) Kazandjian DG, et al: Characterization of patients treated with a programmed cell death protein 1 inhibitor (anti-PD-1) past RECIST progression from a metastatic non-small cell lung cancer (mNSCLC) trial. Abstract 3000, ASCO Annual Meeting, 2016. 8) Reck M, et al: Pembrolizumab versus Chemotherapy for PD-L1-Positive Non-Small-Cell Lung Cancer. N Engl J Med 375: 1823-1833, 2016. 18) Chae YK, et al: Biomarkers for PD-1/PD-L1 blockade therapy in non-small-cell lung cancer: is PD-L1 expression a good marker for patient selection? Clin Lung Cancer 17: 350-361, 2016. 1) Dunn GP, et al: Cancer immunoediting: from immunosurveillance to tumor escape. Nat Immunol 3: 991-998, 2002. 20) Champiat S, et al: Management of immune checkpoint blockade dysimmune toxicities: a collaborative position paper. Ann Oncol 27: 559-574, 2016. 7) Herbst RS, et al: Pembrolizumab versus docetaxel for previously treated, PD-L1-positive, advanced non-small-cell lung cancer (KEYNOTE-010): a randomised controlled trial. Lancet 387: 1540-1550, 2016. 15) Gettinger SN, 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 Clin Oncol 33: 2004-2012, 2015. 14) Di Giacomo AM, et al: Therapeutic efficacy of ipilimumab, an anti-CTLA-4 monoclonal antibody, in patients with metastatic melanoma unresponsive to prior systemic treatments: clinical and immunological evidence from three patient cases. Cancer Immunol Immunother 58: 1297-1306, 2009. |
| References_xml | – reference: 17) Hirsch FR, et al: PD-L1 immunohistochemistry assays for lung cancer: results from phase 1 of the blueprint PD-L1 IHC assay comparison project. J Thorac Oncol 12: 208-222, 2017. – reference: 5) Brahmer J, et al: Nivolumab versus Docetaxel in advanced squamous-cell non-small-cell lung cancer. N Engl J Med 373: 123-135, 2015. – reference: 8) Reck M, et al: Pembrolizumab versus Chemotherapy for PD-L1-Positive Non-Small-Cell Lung Cancer. N Engl J Med 375: 1823-1833, 2016. – reference: 18) Chae YK, et al: Biomarkers for PD-1/PD-L1 blockade therapy in non-small-cell lung cancer: is PD-L1 expression a good marker for patient selection? Clin Lung Cancer 17: 350-361, 2016. – reference: 19) Singh H, et al: FDA subset analysis of the safety of nivolumab in elderly patients with advanced cancers. Abstract 10010, ASCO Annual Meeting, 2016. – reference: 6) Borghaei H, et al: Nivolumab versus Docetaxel in advanced nonsquamous non-small-cell lung cancer. N Engl J Med 373: 1627-1639, 2015. – reference: 1) Dunn GP, et al: Cancer immunoediting: from immunosurveillance to tumor escape. Nat Immunol 3: 991-998, 2002. – reference: 10) Chiou VL, Burotto M: Pseudoprogression and immune-related response in solid tumors. J Clin Oncol 33: 3541-3543, 2015. – reference: 14) Di Giacomo AM, et al: Therapeutic efficacy of ipilimumab, an anti-CTLA-4 monoclonal antibody, in patients with metastatic melanoma unresponsive to prior systemic treatments: clinical and immunological evidence from three patient cases. Cancer Immunol Immunother 58: 1297-1306, 2009. – reference: 3) Ishida Y, et al: Induced expression of PD-1, a novel member of the immunoglobulin gene superfamily, upon programmed cell death. EMBO J 11: 3887-3895, 1992. – reference: 11) Hodi FS, et al: Evaluation of immune-related response criteria and RECIST v1.1 in patients with advanced melanoma treated with pembrolizumab. J Clin Oncol 34: 1510-1517, 2016. – reference: 4) Leach DR, et al: Enhancement of antitumor immunity by CTLA-4 blockade. Science 271: 1734-1736, 1996. – reference: 16) Gibney GT, et al: Predictive biomarkers for checkpoint inhibitor-based immunotherapy. Lancet Oncol 17: e542-e551, 2016. – reference: 9) Nishio M, et al: Multicentre phase II study of nivolumab in Japanese patients with advanced or recurrent non-squamous non-small cell lung cancer. ESMO Open 1: e000108, 2016. – reference: 12) Kazandjian DG, et al: Characterization of patients treated with a programmed cell death protein 1 inhibitor (anti-PD-1) past RECIST progression from a metastatic non-small cell lung cancer (mNSCLC) trial. Abstract 3000, ASCO Annual Meeting, 2016. – reference: 13) Hodi FS, et al: Immunologic and clinical effects of antibody blockade of cytotoxic T lymphocyte-associated antigen 4 in previously vaccinated cancer patients. Proc Natl Acad Sci U S A 105: 3005-3010, 2008. – reference: 15) Gettinger SN, 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 Clin Oncol 33: 2004-2012, 2015. – reference: 2) Schreiber RD, et al: Cancer immunoediting: integrating immunity's roles in cancer suppression and promotion. Science 331: 1565-1570, 2011. – reference: 20) Champiat S, et al: Management of immune checkpoint blockade dysimmune toxicities: a collaborative position paper. Ann Oncol 27: 559-574, 2016. – reference: 7) Herbst RS, et al: Pembrolizumab versus docetaxel for previously treated, PD-L1-positive, advanced non-small-cell lung cancer (KEYNOTE-010): a randomised controlled trial. Lancet 387: 1540-1550, 2016. |
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| Snippet | 免疫チェックポイント阻害薬（immune checkpoint inhibitor：ICI）であるnivolumabおよびpembrolizumabは，新たな一次治療および二次治療以降の選択肢として，進行期非小... |
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| Title | 5．進行期非小細胞肺癌における免疫チェックポイント阻害薬の可能性と課題 |
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