非小细胞肺癌免疫治疗研究进展

Advances of immunotherapy in the treatment of non-small cell lung cancer

免疫系统在预防和抵抗肿瘤生长中起着非常重要的作用。然而,肿瘤细胞会利用一系列本来是为了防止自身免疫的机制来避开免疫监视,如劫持与T细胞活化相关的免疫检查点等。目前,靶向T细胞调节通路上的免疫检查点以增强抗肿瘤免疫反应的治疗药物开发已经取得重要进展,并在临床治疗晚期非小细胞肺癌患者时导致出现了长期缓解例,疗效似与肿瘤细胞程序性死亡受体配体-1的表达相关。使用这类药物的联合治疗,包括与其他免疫检查点抑制剂、化疗药物和分子靶向药物等的联合治疗,现也在进行临床探索,有希望在将来改善非小细胞肺癌患者的预后。

The immune system plays an important role in preventing and combating the growth of tumors. However, the tumor can escape immunosurveillance by exploiting a series of immune escape mechanisms that are developed to avoid autoimmunity. Among these mechanisms is the hijacking of immune checkpoints that are induced on T-cell activation. Immune checkpoint therapy, which targets regulatory pathways in T-cells to enhance antitumor immune responses, has led to important clinical advances and provided a new weapon against cancer. This therapy has elicited durable clinical responses and long-term survival, especially in a fraction of patients with advanced non-small cell lung cancer （NSCLC）, and the activity seems relative to the expression status of tumor programmed cell death receptor ligand-1. Combinatorial approaches with other immune checkpoint inhibitors, chemotherapy, or targeting agents are being explored in ongoing clinical trials, which may improve the outcome in NSCLC.