PD-1/PD-L1信号通路阻滞剂在晚期非小细胞肺癌的临床应用

Clinical Application of PD-1/PD-L1 Signal Pathway Blocker in the Treatment of Advanced Non-Small Cell Lung Cancer

免疫逃逸是癌症形成的重要机制。PD-1／PD—L1免疫检查点分子信号通路参与了肿瘤免疫逃逸，PD-1／PD—L1信号通路阻滞剂通过阻断该通路发挥抗肿瘤作用。PD-1／PD—L1信号通路阻滞剂包括Pembrolizumab、Nivolumab和Atezolizumab等，已有国际多中心的临床试验将其应用于治疗晚期非小细胞肺癌（NSCLC）的临床实践，纳入的患者约一半年龄超过60岁，并显示了良好的耐受性和长期生存获益，然而发现只有不到20％的患者能从中获益，因此需要更精准靶向的选择病人提高有效率，且联合其他药物达到最大临床获益。本文将就PD-1／PD—L1单抗在NSCLC的作用机制、临床应用、如何选择病人进行综述。

Immune escape is one of the mechanisms of cancer development. PD - 1/PD - L1 immune checkpoints molecu- lar signaling pathway play important role in immune escape of cancer. PD - 1/PD - L1 blockers exert anticancer effects by blocking the signaling pathway. PD- 1/PD -L1 signaling blockers （Pembrolizumab, Nivolumab,＂ and Atezolizumab） have been used to treat patients with advanced non - small cell lung cancer （NSCLC） in an international multicenter clinical trial. About 50% of patients in- volved were older than 60 years of age. However, less than 20% of patients benefit from the treatment. Therefore, selecting appro- priate patients and combining with other agents are crucial to improve the therapeutic efficacy. This review article briefly overviews the mechanism, clinical application and selection of patients in the treatment of NSCLC with PD - 1/PD - L1 antibodies.