dostarlimab 多塔利单抗

‌Dostarlimab‌ is a humanized monoclonal antibody that belongs to the ‌PD-1 inhibitor‌ class of drugs. It activates the immune system to attack tumor cells by blocking the PD-1/PD-L1 signaling pathway. It is currently mainly used to treat specific cancer types such as endometrial cancer and mismatch repair defect (dMMR) solid tumors, especially in advanced or recurrent cases.

Mechanism of Action and Indications
‌Mechanism of Action‌
Dostarlimab targets and binds to the ‌PD-1 receptor, preventing the PD-L1 molecules on the surface of tumor cells from binding to the PD-1 of immune T cells, thereby relieving the tumor’s suppression of the immune system and restoring the ability of T cells to recognize and kill cancer cells.

‌Main Indications‌

‌Endometrial cancer‌: FDA approved for the treatment of advanced or recurrent endometrial cancer with ‌dMMR or microsatellite high instability (MSI-H), especially cases that have progressed after platinum-containing chemotherapy.
Solid tumors: Suitable for patients with advanced solid tumors with dMMR (such as colorectal cancer, gastric cancer, etc.) as a second-line or subsequent treatment option. Other studies: Conduct clinical trials in cancers such as ovarian cancer and cervical cancer to explore combination therapy or expand indications. Usage and efficacy Dosage: Usually by intravenous infusion once every 3 weeks, the dose is adjusted according to body weight (such as 500 mg/time). Efficacy data In endometrial cancer, the objective response rate (ORR) is about 40%-45%, and some patients achieve long-term remission. The disease control rate (DCR) of dMMR solid tumors can reach more than 50%, and the survival of some patients is significantly prolonged. Safety and side effects Common side effects (incidence>10%) Fatigue, rash, diarrhea, joint pain, thyroid dysfunction, etc., most of which are mild to moderate. ‌Serious adverse reactions‌
Immune-related adverse reactions (such as pneumonia, colitis, and hepatitis) should be watched out for, with an incidence of about 5%-10%, and timely intervention is required.
‌Contraindications and monitoring‌
Use with caution in patients with active autoimmune diseases; liver and kidney function, thyroid function, and lung imaging should be monitored regularly during treatment.
Research progress and limitations
‌Combination therapy‌: Combined with chemotherapy, targeted drugs, or other immune drugs (such as CTLA-4 inhibitors) to explore the possibility of enhancing efficacy.
‌Biomarkers‌: dMMR/MSI-H status is an important predictor of efficacy, but some patients still have drug resistance problems.
‌Limitations‌
Limited efficacy for non-dMMR tumors; long-term survival data still need to be accumulated; treatment costs are high, and accessibility needs to be improved.
Summary
Dotalizumab provides a new treatment option for patients with specific types of cancer, especially for dMMR/MSI-H tumors. Its application must strictly follow the indications and formulate a plan in combination with genetic test results. Patients should use it under the guidance of a doctor and closely monitor adverse reactions.