目前胸腺上皮肿瘤的免疫治疗:叙述性回顾。

Mediastinum (Hong Kong, China) Pub Date : 2024-10-11 eCollection Date: 2024-01-01 DOI:10.21037/med-24-24
Yoko Yamamoto, Kota Iwahori, Yasushi Shintani
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引用次数: 0

摘要

背景与目的:胸腺上皮性肿瘤(TETs)是血管前纵隔室最常见的肿瘤,其特点是罕见且临床表现多变。本研究旨在探讨目前TET患者的管理,特别关注晚期疾病的免疫治疗。方法:使用检索词“胸腺瘤”、“胸腺癌”、“重症肌无力”、“放射治疗”、“手术”和“免疫治疗”在PubMed中检索1981年至2024年间发表的相关研究。主要内容和发现:国际胸腺恶性肿瘤兴趣小组和国际肺癌研究协会基于回顾性国际数据库的总生存(OS)分析,建立了TET的肿瘤-淋巴结-转移(TNM)分期系统。虽然完全手术切除是可切除TET的主要方法,但由于该病的复杂性、罕见性和异质性以及缺乏体内和体外模型,目前尚无明确的系统性治疗晚期TET的指导方针。随着免疫疗法的发展,抗程序性细胞死亡-1 (anti-PD-1)抗体的应用范围不断扩大,其中包括TET。免疫检查点抑制剂(ICIs)的临床试验正在进行中,抗pd -1抗体治疗TET的临床疗效已被报道。另一方面,有报道称TET中严重免疫相关不良事件(irAEs)发生率增高。结论:ICIs对TET患者具有潜在的治疗作用。对于这些患者,需要仔细评估ICI治疗的效益-毒性比。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Current immunotherapy for thymic epithelial tumors: a narrative review.

Background and objective: Thymic epithelial tumors (TETs) are the most common neoplasm of the prevascular mediastinal compartment and are characterized by their rarity and variable clinical presentation. The present study aimed to explore the current management of patients with TET with a special focus on immunotherapy for advanced disease.

Methods: Relevant studies published between 1981 and 2024 were searched in PubMed using search terms "Thymoma", "Thymic cancer", "Myasthenia gravis", "Radiation therapy", "Surgery", and "Immunotherapy".

Key content and findings: The International Thymic Malignancy Interest Group and the International Association for the Study of Lung Cancer established the tumor-node-metastasis (TNM) staging system for TET based on an overall survival (OS) analysis of a retrospective international database. While complete surgical resection is the mainstay for resectable TET, there are currently no clear guidelines on systemic treatments for advanced TET because of the complexity, rarity, and heterogeneity of this disease and the lack of in vivo and in vitro models. With the development of immunotherapy, the application of the anti-programmed cell death-1 (anti-PD-1) antibody is expanding and includes TET. Clinical trials on immune checkpoint inhibitors (ICIs) are ongoing, and the acceptable clinical efficacy of the anti-PD-1 antibody for TET has been reported. On the other hand, there have been reports of a heightened frequency of severe immune-related adverse events (irAEs) in TET.

Conclusions: ICIs have the potential for patients with TET. The benefit-toxicity ratio of ICI treatment needs to be carefully evaluated for those patients.

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