免疫治療在轉移性泌尿道癌症之應用及現狀：回顧與展望

10.6666/ClinMed.201805_81(5).0051

賴峻毅；張牧新

轉移性治尿道癌症(metastatic urothelial cancer, mUC) ； 免疫檢查點抑制劑(checkpoint inhibitor)

臨床醫學月刊

81卷5期（2018 / 05 / 25）

280 - 285

繁體中文

癌症的藥物治療日新月異，從傳統化學治療，標靶治療，每次新的治療出現都為病人預後帶來進步。近年來免疫治療在許多癌症都得到良好效果.使用在肺癌，頭頸癌等癌症都對疾病有明顯助益。轉移性泌尿道癌症(metastatic urothelial cancer, mUC)是封死車十分高的癌症，傳統化療對其效果也較為有限.免疫治療藥物在轉移性泌尿道癌症過去兩年有數個臨床試驗發表，均有一定療效。也因此美國和歐盟均已有通過免疫治療使用於轉移性泌尿道癌症的案例。本文探討目前現有的免疫療法使用在轉移性泌尿道癌之臨床試驗結果及實證強度，對這類癌症之治療提供綜合性回顧與分析。

1. Alexandrov, LB,Nik-Zainal, S,Wedge, DC(2013).Signatures of mutational processes in human cancer.Nature,500,415-421.
2. Antonia, SJ,Lopez-Martin, JA,Bendell, J(2016).Nivolumab alone and nivolumab plus ipilimumab in recurrent small cell lung cancer (Checkmate 032): a multicentre, open-label, phase 1/2 trial.The Lancet Oncology,17,883-895.
3. Apolo, AB,Infante, JR,Balmanoukian, A(2017).Avelumab, an Anti-Programmed Death-Ligand 1 Antibody, In Patients With Refractory Metastatic Urothelial Carcinoma: Results From a Multicenter, Phase Ib Study.J Clini Oncol,35,2117-2124.
4. Bellmunt, J,de Wit, R,Vaughn, DJ(2017).Pembrolizumab as Second-Line Therapy for Advanced Urothelial Carcinoma.The New England journal of medicine,376,1015-1026.
5. De Santis, M,Bellmunt, J,Mead, G(2012).Randomized phase II/III trial assessing gemcitabine/carboplatin and methotrexate/carboplatin/vinblastine in patients with advanced urothelial cancer who are unfit for cisplatin-based chemotherapy: EORTC study 30986.J Clin Oncol,30,191-199.
6. Lee, HT,Lee, JY,Lim, H(2017).Molecular mechanism of PD-1/PD-L1 blockade via anti-PD-L1 antibodies atezolizumab and durvalumab.Scientific Reports,7,5532.
7. Martin-Liberal, J,Kordbacheh, T,Larkin, J(2015).Safety of pembrolizumab for the treatment of melanoma.Expert Opin Drug Saf,14,957-964.
8. Oing, C,Rink, M,Oechsle, K,Seidel, C,von Amsberg, G,Bokemeyer, C(2016).Second Line Chemotherapy for Advanced and Metastatic Urothelial Carcinoma: Vinflunine and Beyond-A Comprehensive Review of the Current Literature.J Urol,195,254-263.
9. Patel, MR,Ellerton, J,Infante, JR(2018).Avelumab in metastatic urothelial carcinoma after platinum failure (JAVELIN Solid Tumor): pooled results from two expansion cohorts of an open-label, phase 1 trial.The Lancet Oncology,19,51-64.
10. Plimack, ER,Bellmunt, J,Gupta, S(2017).Safety and activity of pembrolizumab in patients with locally advanced or metastatic urothelial cancer (KEYNOTE-012): a non-randomised, open-label, phase 1b study.The Lancet Oncology,18,212-220.
11. Powles, T,Duran, I,van der Heijden, MS(2018).Atezolizumab versus chemotherapy in patients with platinum-treated locally advanced or metastatic urothelial carcinoma (IMvigor211): a multicentre, open-label, phase 3 randomised controlled trial.Lancet,391,748-757.
12. Powles, T,O'Donnell, PH,Massard, C(2017).Efficacy and Safety of Durvalumab in Locally Advanced or Metastatic Urothelial Carcinoma: Updated Results From a Phase 1/2 Open-label Study.JAMA oncology,3,e172411.
13. Rosenberg, JE,Hoffman-Censits, J,Powles, T(2016).Atezolizumab in patients with locally advanced and metastatic urothelial carcinoma who have progressed following treatment with platinum-based chemotherapy: a single-arm, multicentre, phase 2 trial.Lancet,387,1909-1920.
14. Sharma, P,Retz, M,Siefker-Radtke, A(2017).Nivolumab in metastatic urothelial carcinoma after platinum therapy (Checkmate 275): a multicentre, single-arm, phase 2 trial.The Lancet Oncology,18,312-322.
15. Zichi, C,Tucci, M,Leone, G(2017).Immunotherapy for Patients with Advanced Urothelial Cancer: Current Evidence and Future Perspectives.Biomed Research International,2017,5618174.