安徽—恶性淋巴瘤免疫治疗进展.pptVIP

恶性淋巴瘤免疫治疗进展 陈振东 安徽医科大学第二附属医院肿瘤中心 霍奇金淋巴瘤：背景 HL, Classic type, 95% past 40 years, 86% will live 5 years after diagnosis. 20% to 30% relapse after initial treatment or will not respond to therapy at all. Such patients: autologous stem-cell transplantation (ASCT). newer treatment regimen + brentuximab vedotin, many patients eventually worsens. CBT治疗HL有效的机制[Roemer MG, Advani RH, Ligon AH, et al: PDL1 and PD-L2 genetic alterations de?ne classical Hodgkin lymphoma and predict outcome. J Clin Oncol 34:2690-2697, 2016 ]. Reed-Sternberg cells from genetic changes. Which result in an abundance of immune checkpoint molecules PD-L1 and PD-L2. cHL, PD-L1 and PD-L2 molecules were found in 97% of the 108 specimens tested response rates to PD-1 inhibitors are higher in classic HL than in any other type of cancer studied to date. CBT，checkpoint blockade therapy， (免疫)检查点阻滞治疗 CBT治疗HL有效的机制[Roemer MG, Advani RH, Ligon AH, et al: PDL1 and PD-L2 genetic alterations de?ne classical Hodgkin lymphoma and predict outcome. J Clin Oncol 34:2690-2697, 2016 ]. 病理类型影响PD-L1、2表达 86% nodular sclerosis, 11% mixed-cellularity 3% not otherwise speci?ed. 病期影响基因扩增、预后 Ampli?cation of 9p24.1 is more common in patients with advanced stage disease （III/IV） and associated with shorter PFS in this series. CBT治疗HL有效的机制[Roemer MG, Advani RH, Ligon AH, et al: PDL1 and PD-L2 genetic alterations de?ne classical Hodgkin lymphoma and predict outcome. J Clin Oncol 34:2690-2697, 2016 ]. chromosome 9p24.1, resulting in overexpression of the PD-1 ligands PD-L1 and PD-L2 on the tumour cell surface. JAK2 is also located on chromosome 9p24.1, and alterations in this gene increase JAK–STAT signalling, further inducing PD-L1 overexpression. PD-1 免疫检查点抑制剂有效的机制：NHL表达PD-L1、2与cHL不同 25% of DLBCL tumors express PD-1/PD-L1 [Andorsky et? al. 2011] primary mediastinal B-cell lymphoma (PMBL) which, similar to HL，frequently harbors 9p22 amplification leading to overexpression of PD-L1/PD-L2 [Shi