驱动基因阴性晚期非小细胞肺癌一线免疫治疗耐药评估及治疗策略中国专家共识(2024版)

Chinese expert consensus on evaluation and treatment of advanced non-small cell lung cancer with negative driver genes after first-line immunotherapy resistance (2024 edition)

免疫治疗目前已成为驱动基因阴性晚期非小细胞肺癌(NSCLC)一线治疗的标准治疗方案,明显改善了患者预后。然而,对于一线免疫治疗耐药后的评估及治疗方案目前尚缺乏一致性的指南或共识。中国临床肿瘤学会非小细胞肺癌专业委员会组织了肿瘤内科、呼吸内科、胸外科、放疗科、影像科等多学科专家,根据现有循证医学证据,针对驱动基因阴性晚期NSCLC患者一线免疫治疗耐药后的定义与分类、评估标准以及后续治疗策略进行了深入讨论,就原发性和继发性耐药的判定、免疫治疗疗效评估标准的选择、寡进展的判定及治疗策略、广泛进展的治疗策略、免疫治疗再挑战及新型药物临床研究等问题形成相关推荐意见,经过共识会议形成了驱动基因阴性晚期NSCLC一线免疫治疗耐药评估及治疗策略专家共识,旨在为临床实践提供规范化引导。

Immunotherapy has become the standard first-line treatment for advanced non-small cell lung cancer(NSCLC)with negative driver genes,which has significantly improved the prognosis of patients.However,there is still a lack of consistent guidelines or consensus on evaluation and treatment regimens after first-line immunotherapy resistance.The Committee of Non-Small Cell Lung Cancer of Chinese Society of Clinical Oncology organized multidisciplinary experts from medical oncology,respiratory medicine,thoracic surgery,radiotherapy,and imaging to conduct an in-depth discussion on the definition and classification of primary resistance and secondary resistance,evaluation criteria of immunotherapy,subsequent treatment strategies of oligo-progression or extensive progression after first-line immunotherapy,re-challenges of immunotherapy and clinical research of new drugs in advanced NSCLC patients with negative driver genes according to the existing evidence.After the consensus meeting,an expert consensus on evaluation and treatment strategy of advanced NSCLC with negative driver genes after first-line immunotherapy resistance was formed,aiming to provide standardized guidance for clinical practice of Chinese clinicians.