Lessons from neoadjuvant immunotherapy in melanoma: understanding antitumour immunity and tumour escape.

IF 60.9 1区 医学 Q1 IMMUNOLOGY
Francesca Fallarino,Christian U Blank
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Abstract

Immunotherapy has become a fourth pillar of cancer therapy, alongside surgery, radiotherapy and chemotherapy. Cancer immunotherapy seems to be most effective in the context of low but not negligible tumour burden, thus in the neoadjuvant setting before curative intent surgery. Indeed, in the case of macroscopic stage III melanoma, a decade of clinical and translational research has led to conclusive evidence that neoadjuvant immunotherapy should be the clinical standard of care, although its adoption in different regions of the world is still ongoing. In this Perspective, we discuss the lessons learnt from neoadjuvant immunotherapy trials in melanoma and where the field is heading next. In the coming years, we believe that biomarker-driven personalization of the therapy, a deeper understanding of the role of immune education, and the ability to uncouple toxicity from efficacy will make neoadjuvant cancer immunotherapy safer and more effective, not only for melanoma but also for other types of cancer.
黑色素瘤新辅助免疫治疗的经验教训:了解抗肿瘤免疫和肿瘤逃逸。
免疫疗法已成为继手术、放疗和化疗之后癌症治疗的第四大支柱。肿瘤免疫治疗似乎在肿瘤负荷低但不可忽略的情况下最有效,因此在治疗目的手术前的新辅助设置。事实上,在宏观III期黑色素瘤的病例中,十年的临床和转化研究已经得出确凿的证据,表明新辅助免疫治疗应该是临床治疗的标准,尽管它在世界不同地区的采用仍在进行中。从这个角度来看,我们讨论了从黑色素瘤的新辅助免疫治疗试验中吸取的教训,以及该领域的下一步发展方向。在未来几年,我们相信生物标志物驱动的个性化治疗,对免疫教育作用的更深入理解,以及将毒性与疗效分离的能力,将使新辅助癌症免疫治疗更安全、更有效,不仅适用于黑色素瘤,也适用于其他类型的癌症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Nature Reviews Immunology
Nature Reviews Immunology 医学-免疫学
CiteScore
93.40
自引率
0.40%
发文量
131
审稿时长
6-12 weeks
期刊介绍: Nature Reviews Immunology is a journal that provides comprehensive coverage of all areas of immunology, including fundamental mechanisms and applied aspects. It has two international standard serial numbers (ISSN): 1474-1733 for print and 1474-1741 for online. In addition to review articles, the journal also features recent developments and new primary papers in the field, as well as reflections on influential people, papers, and events in the development of immunology. The subjects covered by Nature Reviews Immunology include allergy and asthma, autoimmunity, antigen processing and presentation, apoptosis and cell death, chemokines and chemokine receptors, cytokines and cytokine receptors, development and function of cells of the immune system, haematopoiesis, infection and immunity, immunotherapy, innate immunity, mucosal immunology and the microbiota, regulation of the immune response, signalling in the immune system, transplantation, tumour immunology and immunotherapy, and vaccine development.
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