Médecine sciences : M/S
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Médecine sciences : M/S · Dec 2019
Review[Toxicities of immune checkpoint inhibitors and their management].
Immunotherapeutic strategies, notably immune checkpoint inhibitors, have become a standard of care for the treatment of advanced cancers, with a growing spectrum of activity. These monoclonal antibodies target the co-inhibitory signals between tumor cells or antigen-presenting cells and T cells, thereby enhancing antitumour T cell activity. However, the occurrence of immune-related adverse events, that can affect all organ-system, represents a major limiting factor to the clinical development of these antibodies. Management of such toxicity requires a close collaboration between oncologists and organ-specialists, by using glucocorticoids and/or other immunosuppressive therapies, with the common objective not alter anti-tumor response.
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Médecine sciences : M/S · Dec 2019
Review Historical Article[Antibody-drug conjugates in oncology. New strategies in development].
An Antibody-Drug Conjugate (armed antibody) is a vectorized chemotherapy that results from the grafting of a cytotoxic agent on a monoclonal antibody via a judiciously designed spacer arm. ADCs have made considerable progress in 10 years. ⋯ The second part of this review will focus on new emerging strategies to address ADCs drawbacks and attempt to broaden their therapeutic window. Finally, combinations with conventional chemotherapy or checkpoint inhibitors will be discussed, in the pursuit to make Antibody-Drug Conjugates the embodiment of Paul Ehrlich's dream of the magic bullet.
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Médecine sciences : M/S · Dec 2019
Review[The revolution of immuno-oncology therapy: review of immune checkpoint inhibitors efficacy].
Immunotherapy represents a major paradigm shift, as the treatment no longer directly targets tumor cells, but the patient him/herself, in order to restore an effective anti-tumor immunity. This article illustrates the growing place of immune checkpoint inhibitors in the available therapeutic options, by focusing on two cancers with poor outcome: metastatic melanoma and metastatic non-small cell lung cancer (NSCLC), against which Immune checkpoints inhibitors now occupy a central place. Many questions remain unresolved, such as the search for markers predicting a good response to treatment, which would allow the selection of responder patients. Numerous trials are in progress, evaluating the relevance of these new molecules at earlier stages of the disease (adjuvant and neoadjuvant strategies) and their place in combined strategies (associated with chemotherapy, targeted therapies, and other types of immunotherapy).
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Médecine sciences : M/S · Dec 2019
Review[The revolution of immuno-oncology therapy: specificities for the physicians].
The use of immune checkpoint inhibitors has revolutionized the treatment and prognosis of many cancer patients. Associated with the raise of these new treatments, new side effects have been observed, requiring specific management. ⋯ Many other therapeutic targets exist and could potentially be associated with immune checkpoint inhibitors. Many challenges still need to be overcome in order to better understand and optimize the use of these new molecules.
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Médecine sciences : M/S · Dec 2019
Review[Anti-GD2 antibodies in treatment of high-risk Neuroblastoma: present and perspectives].
Neuroblastoma is the most frequent extra-cranial pediatric solid tumor, occurring in young children, 90% being less than 5 years at diagnosis. It remains a therapeutic challenge since survival of high-risk neuroblastoma patients that represent around 50% of the patients is around 50% in spite of extensive combined treatments. ⋯ Other strategies are currently explored using combination with chemotherapy at relapse and evaluating the benefits of an earlier administration during the induction treatment. In addition, more selective antibodies are also developed to decrease toxicity, especially neuropathic pain that is one of the major toxic effect.