小细胞肺癌治疗的困境与希望

Treatment of small cell lung cancer:Challenges and prospects

目前,小细胞肺癌(SCLC)的一二线标准治疗仍是化疗。SCLC对初始治疗敏感,但多数患者会出现转移复发。近年来,免疫治疗在SCLC治疗中取得了一定进展,纳武单抗、派姆单抗以及阿特珠单抗在SCLC治疗中都表现出卓越的疗效,免疫治疗正在改变传统的一线治疗策略。靶向治疗方面,抗体耦联药物lurbinectedin则凭借39.3%的客观缓解率获得FDA的孤儿药称号。安罗替尼三线及以上治疗SCLCⅡ期临床试验(ALTER 1202)主要研究终点无进展生存期及次要研究终点总生存期和疾病控制率已经达到,并取得了非常好的治疗结果。未来,一线化疗后的安罗替尼维持治疗、安罗替尼联合免疫治疗以及安罗替尼治疗的优势人群探索都将是后续研究的重要方向之一。

Currently, chemotherapy remains the first- and second-line standard treatment of small cell lung cancer （SCLC）. line treatment strategies. In terms of targeted therapies, the antibody-conjugated drug lubbinectedin was granted Orphan Drug Designation by US FDA for its objective response rate of 39.3%. Goals have been achieved in the primary endpoint of progression-free survival, secondary endpoint overall survival and disease control rate of the third-line or further treatment of SCLC in phase-Ⅱ ALTER 1202 trial of anlotinib, with satisfactory therapeutic results. Anlotinib maintenance therapy after first-line chemotherapy, anlotinib combined with immunotherapy, and identification of the population truly suitable for anlotinib treatment will be most important directions for the future studies.