四年前,鮑勃-卡爾森(Bob Carlson)得知自己患有肺癌,可能活不過兩年。他經歷了“女巫魔法藥水”般的化療,然而每一次化療最終均告失敗,化療過程令這位72歲的退休員工覺得生不如死。後來耶魯大學附屬斯麥咯腫瘤醫院(Smilow Cancer Hospital)對他進行羅氏集團康涅狄格分公司一款抗癌藥物的早期臨床試驗。這是一種幫助患者免疫系統發現、抗擊癌細胞的新型藥物。經過羅氏新藥治療,凱爾森的腫瘤縮小了,而且沒有化療的毒副作用。卡爾森用藥至今已有兩年,腫瘤持續縮小。
[1]. FDA Approves Keytruda For Advanced Melanoma—First PD-1 Blocking Drug To Receive Agency Approval. (Sep. 4, 2014). Retrieved From Http://Www.Fda.Gov/NewsEvents/Newsroom/PressAnnouncements/Ucm412802.Htm
[2]. FDA Approves Opdivo For Advanced Melanoma. (Dec. 22, 2014). Retrieved From Http://Www.Fda.Gov/Newsevents/Newsroom/Pressannouncements/Ucm427716.Htm
[3]. Common Cancer Types. (Jan. 26, 2015). Retrieved From Http://Www.Cancer.Gov/Cancertopics/Types/Commoncancers
[4]. Global Cancer Statistics. (Feb. 2, 2015). Retrieved From Http://Www.Cdc.Gov/Cancer/International/Statistics.Htm
[5]. Lung Cancer (Non-Small Cell). (Mar. 4, 2015). Retrieved From Http://Www.Cancer.Org/Cancer/Lungcancer-Non-Smallcell/Detailedguide/Non-Small-Cell-Lung-Cancer-What-Is-Non-Small-Cell-Lung-Cancer
[6]. FDA Expands Approved Use Of Opdivo To Treat Lung Cancer. (Mar. 4, 2015). Retrieved From Http://Www.Fda.Gov/NewsEvents/Newsroom/PressAnnouncements/Ucm436534.Htm
[7]. Baum A.S. (Jun. 26, 2013). Immunotherapy – The Beginning Of The End For Cancer. Retrieved From Https://Www.Citivelocity.Com/Citigps/OpArticleDetail.Action?RecordId=209
[8]. Staton T. (Mar. 4, 2015). The PD-1 Wave? Report Says It’s A $33B Tsunami, With BMS Surfing For First Place. Retrieved From Http://Www.Fiercepharmamarketing.Com/Story/Pd-1-Wave-Report-Says-Its-33b-Tsunami-Bms-Surfing-First-Place/2015-03-04
免疫癌症療法的浪潮,在全球正方興未艾;然而卻也不是毫無缺點。例如:在Nivolumab第二期臨床試驗中,有14%受試者出現較嚴重的Grade 3-4藥物副作用,甚至有三位患者死於免疫反應相關的肺病變。 也有其他專家認為Ipilimumab 或Nivolumab在臨床試驗中對癌症的整體治癒率還是太低,病患的長期存活率不明;但是YERVOY™ (Ipilimumab)一個療程的費用就高達12萬美元,所費不貲。但無論如何,YERVOY™ (Ipilimumab)與OPDIVO® (Nivolumab)為癌症治療開啟了全新的視野:第一次以患者的免疫細胞為治療對象,而不是癌細胞。此外,在詹姆斯‧艾利森(James P. Allison)博士、與本庶佑(Tasuku Honjo)博士的「唐獎」得獎感想中,不約而同地都提到了基礎研究的重要性。人類對抗死神癌症的戰役可以說才剛剛開始,更新更好的治療永遠都派得上用場;當然也要負擔得起才行。
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