Immunotherapy: targeting CTLA-4 / B7 axis and PD-1 / PD-L1 axis in anticancer therapy. Part 2. Clinical aspects.



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Abstract

Currently, cancer immunotherapy based on immune checkpoint inhibitors (ICIs) promotes an effective immune response against a variety of solid tumors, including melanoma, non-small cell lung cancer, renal cell carcinoma, prostate cancer etc. Cancer immunotherapy was developed with the aim of inhibition/blocking the signal pathways from Programmed cell death protein 1 (PD-1) and cytotoxic T-lymphocyte antigen 4 (CTLA-4), that play pivotal part in immune cell regulation. Monoclonal antibodies directed against CTLA-4, a negative regulator of T-cell immune function, downregulate Tregs activity, increase co-stimulation signal from antigen-presenting cells and improve the strength of the tumor-specific T-cell against cancer cells. Inhibition of PD-1 or its ligands (PD-L1 and PD-L2) promotes an effective immune response against cancer cells via activation of tumor-specific T-cell b natural killer cells in the tumor microenvironment. ICIs are also notable because they induce a broad spectrum of severe side effects in patients, including toxic hepatitis, pneumonitis, hypophysitis, myocarditis, myositis, nephritis, neurotoxicity, adrenal insufficiency, hematotoxicity etc. However, despite the serious side effects of ICIs, the ICIs based immunotherapy showed promising antitumor activity in treating certain cancers. Furthermore, the majority of side effects are well controlled, and serious side effects can be diagnosed early and prevented from developing. Thus, immune checkpoint inhibitors may be of significant therapeutic value, but some aspects of cancer immunotherapy still require optimization depending on the patient’s individual characteristics.

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About the authors

Andrey Shukshin

Author for correspondence.
Email: andrei.shukshinf@yandex.ru
ORCID iD: 0009-0009-0830-1733
Russian Federation

Artem Rubinstein

Email: arrubin6@mail.ru
ORCID iD: 0000-0002-8493-5211
SPIN-code: 6025-1790

Alexey Golovkin

Email: golovkin_a@mail.ru
ORCID iD: 0000-0002-7577-628X
SPIN-code: 8803-2425

Olga Moiseeva

Email: moiseeva@almazovcentre.ru
ORCID iD: 0000-0002-7817-3847
SPIN-code: 1492-3900

Igor Kudryavtsev

Email: igorek1981@yandex.ru
ORCID iD: 0000-0001-7204-7850
SPIN-code: 4903-7636

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