In recent years, remarkable progress has been made in the treatment of cancer immunotherapy using immune checkpoint inhibitors.
The first approved immune checkpoint inhibitor for lung cancer in Japan is the anti-PD-1 antibody nivolumab.Cancer cells bind molecules such as PD-L1 and PD-L1 to a molecule called PD-2 that is expressed on T lymphocytes, and suppress the activation of T lymphocytes that try to attack the cancer ( Cancer immune avoidance mechanism).Anti-PD-1 antibody inhibits PD-L1 and PD-L1 on cancer cells from binding to PD-2 by binding to PD-1 and activates T lymphocytes. It is a drug that maintains and exerts an antitumor effect.
While this treatment is extremely powerful, it still has problems such as being effective only in a limited number of patients and causing characteristic side effects unique to immunotherapy.It is necessary to monitor the pharmacokinetics of immune checkpoint inhibitors in the body, predict the effects of treatment, and manage side effects.
Under these circumstances, a research group at Osaka University has developed a method for monitoring the expression of PD-1 on T lymphocytes and the binding state of nivolumab from the blood of lung cancer patients who received nivolumab.As a result, it was found that nivolumab binds to T lymphocytes for a long period of 20 weeks or more even after the treatment is stopped due to side effects or ineffective treatment.
In lung cancer, anticancer drugs are often given after discontinuation of nivolumab.The results of this study suggest that some of the therapeutic effects remain even after discontinuation of nivolumab and may work synergistically with the next anticancer drug treatment, and the effects are monitored for a long period of time from the viewpoint of side effects. It was also shown that it should be done.Evaluation of the pharmacokinetics of anti-PD-1 antibody in the body is expected to be useful for selection of next treatment and management of side effects.
Paper information:[JCI insight] Clinical implications of monitoring nivolumab immunokinetics in non–small cell lung cancer patients
