晚期非小细胞肺癌的免疫治疗进展

Progression of Immunotherapy in Advanced Non-small Cell Lung Cancer

免疫治疗是继传统手术、放射治疗(放疗)、化学治疗(化疗)之后逐步发展起来的治疗方法。近年来,免疫治疗因其较高的有效性和安全性在晚期非小细胞肺癌(NSCLC)综合治疗中的地位日渐突出。多个程序性死亡蛋白-1(PD-1)和程序性死亡分子配体-1(PD-L1)抑制药在晚期NSCLC一线、二线治疗中获得适应证;Ⅲ期NSCLC同步放化疗后辅以PD-L1抑制药可显著延长患者无进展生存期。然而,免疫治疗目前只对部分患者有效,晚期NSCLC免疫治疗的模式还需要不断优化,包括免疫治疗联合化疗、免疫治疗联合放疗等多种免疫联合治疗,以扩大获益人群;免疫治疗的疗效及生物标志物指导的精准治疗也在快速发展、提高。

Immunotherapy acts as one of developing therapeutic strategies following traditional surgery,radiation therapy and chemotherapy.Recently,immunotherapy shows increasing importance in the comprehensive treatment of advanced non-small cell lung cancer(NSCLC)because of its significant relaibility and efficacy.Several programmed cell death protein 1/programmed death ligand 1(PD-1/PD-L1)inhibitors have been approved for the treatment of advanced or metastatic NCCLC in first or second-line setting.In addition,immunotherapy with PD-L1 inhibitor promotes progression-free survival in stage III NSCLC patients who received previously concurrent radiation therapy and chemotherapy.However,due to the limited number of patients who could benefit from approved immunotherapy and the aim of expanding benifit groups,the immunotherapy treatment model of advanced NSCLC still needs continuous optimization,which includes immunotherapy combined with chemotherapy or immunotherapy combined with radiation therapy.Tumor marker-based precision therapy and efficacy with immunotherapy are in rapid development and improvement.