Cancer Genetics and Epigenetics 2024, Vol.12, No.1, 15-26 http://www.medscipublisher.com/index.php/cge 18 Despite showing potential in the treatment of uterine endometrial cancer, PD-1/PD-L1 inhibitors still face challenges and limitations. Not all patients respond favorably to PD-1/PD-L1 inhibitor therapy. Further research is required to identify which patients are most sensitive to these drugs. Long-term safety and tolerability of PD-1/PD-L1 inhibitors still need more observation and study. The widespread use of PD-1/PD-L1 inhibitors faces economic constraints due to their high drug costs. PD-1/PD-L1 inhibitors are a class of drugs with potential efficacy for uterine endometrial cancer treatment. Pembrolizumab has shown significant therapeutic effects in clinical trials for uterine endometrial cancer, and other PD-1/PD-L1 inhibitors are also under investigation. However, more research is still needed to determine the optimal application of PD-1/PD-L1 inhibitors in uterine endometrial cancer treatment. Addressing the challenges and limitations they face will provide more effective treatment options and improve the prognosis for uterine endometrial cancer patients (Zhao et al., 2023). 2.2 Clinical research on CTLA-4 inhibitors CTLA-4 inhibitors are a type of immunotherapeutic medication that enhances the body's anti-tumor immune response by blocking the Cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) pathway. In clinical studies, CTLA-4 inhibitors have shown potential therapeutic effects in various types of cancers, including melanoma and non-small cell lung cancer. Currently, one of the most extensively studied drugs among CTLA-4 inhibitors is Ipilimumab. Ipilimumab was the first immunotherapeutic drug approved by the FDA for treating malignant melanoma. It enhances the immune system's attack capabilities by blocking CTLA-4's inhibition of tumor-specific T cells. In the treatment of malignant melanoma, Ipilimumab has been shown to increase patients' survival periods. Apart from melanoma, CTLA-4 inhibitors have made significant progress in clinical studies for other cancer types. For instance, in the treatment of non-small cell lung cancer, combined immune therapy utilizing CTLA-4 inhibitors alongside PD-1 inhibitors has demonstrated promising efficacy. Additionally, CTLA-4 inhibitors have been studied in other cancer types such as renal cell carcinoma, colorectal cancer, and gastric cancer. However, the application of CTLA-4 inhibitors faces challenges and limitations. The therapeutic effects of CTLA-4 inhibitors may come with severe immune-related adverse events, including autoimmune reactions and intestinal inflammation. These adverse events need to be identified and handled in a timely manner to reduce the risk of adverse reactions in patients. CTLA-4 inhibitors may exhibit lower response rates in certain patients, necessitating further research to identify those most sensitive to this class of drugs. Long-term safety and tolerability of CTLA-4 inhibitors still require more observation and study. CTLA-4 inhibitors are a class of immunotherapeutic drugs with potential efficacy for the treatment of various types of tumors. While Ipilimumab has shown remarkable success in the treatment of malignant melanoma, and combination immune therapies have shown some efficacy, further research is needed to determine the optimal application of CTLA-4 inhibitors in different cancer types and address the challenges and limitations they face, in order to provide more effective treatment options and improve the prognosis of tumor patients (Figure 2). 2.3 Application of tumor vaccines 2.3.1 Progress in antigen-specific vaccines Antigen-specific vaccines are designed to activate the immune system using tumor-specific antigens. These antigens can be tumor-associated antigens (TAA) or tumor-specific antigens (TSA). Currently, numerous studies are exploring the potential of antigen-specific vaccines. A common strategy involves using tumor antigen proteins to stimulate the immune system. These proteins can be specific antigens expressed by tumor cells or synthetic recombinant proteins. Injected into patients, these proteins activate antigen-presenting cells, initiating an immune response. Clinical trials have demonstrated the potential efficacy of antigen-specific vaccines in certain cancers like melanoma and prostate cancer. Another strategy for antigen-specific vaccines is to prepare vaccines using tumor cells or components of tumor cells. These vaccines are called whole cell vaccines.
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