Chemotherapy—a viable partner for cancer immunotherapy?
Mené sur 48 patientes atteintes d'un cancer métastatique du sein, cet essai de phase II évalue l'efficacité, du point de vue de la survie sans progression, et la toxicité de l'ajout d'un vaccin thérapeutique (PANVAC, basé sur un poxvirus) au docétaxel
Advances in immuno-oncology began quietly several years ago, when sipuleucel-T, an autologous dendritic cell–based vaccine specific for prostatic acid phosphatase, was approved by the US Food and Drug Administration (FDA) for the treatment of metastatic prostate cancer.2 Next, ipilimumab, a monoclonal antibody specific for the immune checkpoint molecule CTLA-4 (cytotoxic T-lymphocyte antigen-4), was FDA approved for metastatic melanoma.3 Notably, although both agents improve median overall survival by about 3 to 4 months, objective clinical responses are uncommon, and neither improves progression-free survival (PFS). Most recently, long-lasting clinical responses of 10% to 50% in a broad range of solid tumors have been reported with monoclonal antibodies that target PD-1 (programmed death-1) or its ligand PD-L1.4 Some PD-1–specific agents are now FDA approved for metastatic melanoma (pembrolizumab and nivolumab) and advanced non–small-cell lung carcinoma (nivolumab). Their unprecedented clinical activity has ignited an explosion of interest in cancer immunotherapy across the oncology community. The durability of clinical responses to these agents is unique to immunotherapy and primarily reflects the induction and activation of a potent, tumor-specific memory T-cell response that mediates long-term cancer control, improving overall survival.
JAMA Oncology 2015