PD-1/PD-L1 antibody, a milestone in the treatment of cancer

In recent years, the immune drugs represented by &ldquo, PD-1/PD-L1&rdquo have been brilliant in the field of cancer research and treatment, showing encouraging clinical effects and bringing new hope to the rebirth of patients. “ PD-1/PD-L1” is an important part of the human immune system, a drug target on -T cell. The drug designed for this target can activate the immune effect of T cells on tumor cells, thereby awakening the patient's own anti-tumor effect. In recent years, research on this target is endless, and research results are also emerging. By the end of 2016, two drugs for PD-1 and a drug for PD-L1 were listed in the us through FDA approval.

In 2017, let's sort out the things about PD-1/PD-L1 again.

How does PD-1/PD-L1 fight against cancer

In simple terms, tumor immunotherapy is the elimination of tumor cells by activating the immune cells that are suppressed by the human body itself. In our human immune system, there is an important immune cell called T cell. When harmful substances enter the human body, T cells usually induce immune response, thereby eliminating foreign bodies.

But in order to avoid frequent activation of T cells when it is not necessary, it has a complex regulatory mechanism. There are two kinds of proteins on the surface of T cells. One group will cause immune response after stimulation, and the other will inhibit the immune response after being stimulated. These two mechanisms act together, regulate each other, and maintain the balance of the human immune system. However, cunning cancer cells will break this balance. They have a structure on the surface, which can be combined with the surface of T cells to inhibit the immune response, thereby inhibiting the normal function of T cells killing harmful substances and escaping the human immune system. This characteristic of the tumor cells is called the immune escape of the tumor.

Since the immune system in the body will be inhibited when attacked by cancer cells, it can stimulate the immune function of tumor patients to inhibit the tumor cells in vivo, and become an ideal strategy for tumor therapy. This kind of therapy can systematically enhance the anti tumor immune response of the patient and relieve the immunosuppression in the body. At present, there have been a variety of mature products listed, and have achieved good results, which are more representative of the antibodies against CTLA-4, PD-1/PD-L1, and so on.

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By the end of 2016, there were two drugs for PD-1, and a drug for PD-L1 was listed in the United States through FDA approval.

The drug targeting PD-1 were made by Bristol Myers Shi Guibao (BMS) company's Nivolumab (Opdivo), and developed by Merck's Pembrolizumab (Keytruda). The only drug targeted at PD-L1 is that only Roche's Atezolizumab (commodity name Tecentriq) is allowed to be listed in the United States. Also, AstraZeneca's PD-L1 antibody drug, Durvalumab, has also made significant progress, and the drug is currently in progress in a variety of cancers.

Opdivo's approval for the treatment of 5 cancers

Opdivo has been approved by FDA since 2014. The indication has been increasing. The current indications include five cancer species, two of which are approved by FDA for the good clinical trial data. We believe that with the deepening of the research, there will be a breakthrough in the high incidence of liver cancer and gastric cancer in China.

Approved indications:

Advanced non-small cell lung cancer treated by previous treatment;

Melanoma;

Advanced renal cancer with previous treatment.

Head and neck squamous cell carcinoma that has been recrudescence or metastasis after treatment.

The recurrence or metastasis of Hodgkin's lymphoma after autologous stem cell transplantation and Adetris treatment;

In addition, there are still a lot of III clinical studies on Opdivo, and the range of indications is expected to continue to expand. These III studies mainly included the evaluation of the efficacy and safety of Opdivo in the treatment of melanoma, brain metastasis, gastric cancer, bladder tumor or upper urinary tract tumor, esophageal cancer or gastroesophageal junction cancer, hepatocellular carcinoma, malignant glioma and other tumors.

The data of the objective response rate of the latest clinical trials for a series of tumors treated by Opdivo are detailed in the following table:

Keytruda 2016 crossing chemotherapy

In 2016, Keytruda was historically a first-line treatment for non-small cell lung cancer (for PD-L1 high expression of ≥ 50%). Published PD-1 antibody Keytruda for first-line treatment of advanced non-small cell lung cancer clinical data heavy in October last year, the world's top medical journal "new England Journal of Medicine (NCT02142738): PD-L1 (PD-L1 for the strong positive expression of ≥ 50%) of the patients, the use of Keytruda in progression free survival and overall survival were there are significant advantages than chemotherapy.

Other approved indications are:

A melanoma that is not excised or transferred;

Metastatic non-small cell lung cancer;

Squamous cell carcinoma of the head and neck;

There is still a large wave of clinical research on Keytruda for other kinds of cancer, including Hodgkin lymphoma, advanced liver cancer, advanced gastric cancer or gastroesophageal junction cancer, three negative breast cancer and so on.

For the latest efficient data for Keytruda treatment of a series of tumors, please see the following table.

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Tecentriq the first PD-L1 drug approved by the atzumumumab FDA

Tecentriq is a PD-L1 antibody drug, and is the only PD-L1 antibody drug approved by FDA.

Its indications include the following two:

Locally advanced or metastatic urothelial carcinoma;

Metastatic non-small cell lung cancer;

The current research on Tecentriq is mainly about the efficacy of ovarian cancer, renal cell carcinoma, three negative breast cancer, bladder cancer, melanoma and colorectal cancer.

At present, PD-1/PD-L1 inhibitors have not yet been listed on the mainland of China, and patients who want to obtain such drugs can only be purchased from the United States or Hongkong through overseas routes. Hangzhou Health Management Consulting Co., Ltd. provides an overseas medical direct train to help patients travel to cost-effective medical institutions.

Hangzhou medical marketing health management consulting Co., Ltd. provides one-stop international medical consultation service to enable more patients to enjoy the latest international medical achievements. Welcome to call 400-0825-008 hotline.