Researchers have found that recurrent rates for mesothelioma can vary widely, with some studies finding recurrence rates after treatment ranging from 10 – 72%. Even patients diagnosed in the earlier stages and who are able to undergo aggressive multimodal treatment have been found to experience recurrence. Because of the rather high likelihood of the cancer recurring, a heavy focus of mesothelioma research is finding optimal second- and third-line treatments for patients who have previously been treated and either experience recurrence or their cancer is unresponsive.
最新的clinical trials预计将很快在纪念斯隆kettering癌症中心开始，旨在测试最新的免疫疗法药物，一种称为galinpepimut-s的疫苗（有时称为GPS疫苗），并结合另一种免疫疗法药物Nivolumab，两者都显示出有希望的药物导致在先前的研究中延长预期寿命。
galinpepimut-s疫苗如何工作
galinpepimut-S疫苗或GPS疫苗的靶向WT1蛋白，也称为Wilms肿瘤-1。在正常的健康组织中，人类通常以有限的量表达WT1蛋白。多年来，研究人员发现万博专业版还有其他一些类型的癌症通常过表达蛋白质。因此，该蛋白被认为是癌症疫苗的最佳靶标。
Cancer vaccines are a type of免疫疗法通过靶向患者的特定蛋白质来引起免疫系统反应。研究人员也一直在努力制造个性化的癌症疫苗，这是每个患者的独特治疗方法，因为每个人的肿瘤都有自己独特的基因组成。包括癌症疫苗在内的所有类型的免疫疗法，包括间皮瘤，包括癌症研究。万博专业版
The GPS vaccine was created by enhancing the immunogenic effects of the WT1 protein by adding four synthetic peptides (molecules that can play a key role in cell activities and are smaller than proteins). In doing so, researchers noted the effect created stability, motivated T cell recognition, and caused immune cells to react against the native WT1. Overall, their pre-development work showed that WT1 could effectively be used as a cancer vaccine in this combination, with pilot studies showing a high immune response rate among patients.
The upcoming clinical trial will utilize the GPS vaccine with nivolumab (Opdivo®), a PD-1 checkpoint inhibitor. Checkpoint inhibitors work by targeting specific proteins in the cancer cells, like PD-L1, to promote an immune response and stopmesothelioma metastasis. Researchers involved in the new study plan to apply the galinpepimut-S vaccine and nivolumab simultaneously with the belief that nivolumab will enhance the efficacy of GPS by further promoting the immune system’s attack of WT1.
GPS疫苗和Nivolumab先前的成功
Mesothelioma researchers are hopeful for this upcoming clinical trial because of the past success both the GPS vaccine and nivolumab have shown separately in other previous studies.
GPS疫苗临床试验最近在2017年发表了41pleural mesothelioma2011年5月至2015年8月之间的患者。该研究主要包括上皮性间皮瘤患者，尽管有5％的患者被诊断为双相间皮瘤或混合细胞。万博专业版由于对WT1表达的要求，恶性肉瘤性间皮瘤万博专业版患者没有资格进行研究。
galinpepimut-s疫苗被视为二线治疗以前经过的患者mesothelioma surgery, whether an extrapleural pneumonectomy or a type of pleurectomy/decortication, followed by chemotherapy. Some patients also underwent intensity modulated pleural radiotherapy or other types of radiation. On average, about 61 days after these treatments, the GPS vaccine was administered six times every 14 days. The study found that the treatment could be well tolerated, with minimal side effects like nausea.
研究人员发现，未接受疫苗的患者中，无进展生存期为33％，接受GPS治疗的患者为45％。在未接受疫苗的受控组中，疫苗的患者的总生存期为22.8个月，而疫苗的中位生存期为18.3个月。
Nivolumab, or Opdivo, has also seen promising results in a variety of clinical trials, particularly for recurrent or unresponsive mesothelioma. In some of therecent studies，OPDIVO已单独测试，并使用另一种免疫疗法ipilimumab进行了先前治疗的胸膜间皮瘤。万博专业版研究发现，在先前接受化疗后，有50-68％的患者通过联合治疗获得了受控疾病。
研究人员乐观地认为，即将到来的临床试验将进一步改善这些测试免疫疗法药物的研究结果。寻找有效的间皮瘤的有效的二线和三线治疗方法是对抗穷人万博专业版prognosisand high rates of recurrence.
