免疫检查点抑制剂新辅助治疗可切除非小细胞肺癌现状与展望

Current status and prospective of neoadjuvant immune checkpoint inhibitors for resectable non-small cell lung cancer

手术切除是目前可切除非小细胞肺癌(NSCLC)的首要根治性治疗,但不少患者,尤其是中晚期患者,会出现术后复发的情况。寻找能更有效减少复发风险和毒副作用更小的围手术期治疗为当前可切除NSCLC治疗亟待解决的问题之一。免疫检查点抑制剂(ICI)能有效打破肿瘤细胞的免疫逃避机制,已经有部分研究显示ICI新辅助治疗可切除NSCLC能获得不错的可行性、安全性和疗效。但是部分关键问题至今仍然是未知之数,包括ICI新辅助治疗能否最终减少NSCLC术后复发,获益人群的选择以及最佳的治疗方案等。所幸已经有数个Ⅲ期随机对照临床研究正在进行,希望这些大型临床研究能给我们提供更加有力的证据。

Surgery remains as the primary definitive therapy for resectable non-small cell lung cancer(NSCLC) currently.However,quite a few NSCLC patients,especially in the later stage,suffered tumor recurrence after resection.Safer and more effective perioperative treatment is urgently needed to reduce the recurrence risk after NSCLC surgery.Immune checkpoint inhibitors can effectively prevent tumor immune evasion and have been shown to be a feasible,safe and effective neoadjuvant therapy for resectable NSCLC.Nevertheless,certain crucial problems,including the final effect on NSCLC recurrence,the selection of beneficial group and optimal treatment protocol are yet unsolved.Fortunately,several phaseⅢrandomized controlled trials are ongoing to answer these questions and will hopefully provide stronger evidence.