免疫检查点抑制剂在肺癌治疗应用中的挑战与方向

Challenges and directions of immune checkpoint inhibitors in the treatment of lung cancer

近年来,随着对免疫检查点研究的逐渐深入,免疫检查点抑制剂(immune checkpoint inhibitor,ICI)的研究也不断取得突破性进展,这使得肺癌的诊疗发生了革命性的变化。但是ICI在临床应用中仍存在获益人群有限、缺乏有效的生物标志物、治疗耐药及缺乏精准联合治疗方案等诸多问题和挑战。就程序性死亡[蛋白]配体-1(programmed death ligand-1,PD-L1)、肿瘤突变负荷(tumor mutation burden,TMB)作为常用ICI标志物的价值、局限性、其他潜在的新型生物标志物、免疫耐药的监测及应对、如何实现精准化免疫治疗以及新近取得的新药研发成果进行综述。

In recent years,with the gradual in-depth research on immune checkpoints,breakthroughs have been made in the research of immune checkpoint inhibitors(ICI),which has revolutionized the diagnosis and treatment of lung cancer.However,there are still many problems and challenges in the clinical application,such as the limited benefit population,the lack of effective biomarkers,treatment resistance,and the lack of precise combination treatment programs.This article summarized the value and limitations of programmed death ligand-1(PD-L1)and tumor mutation burden(TMB)as common biomarkers of ICI,as well as other potential new biomarkers,the monitoring and responses to immunological resistance,how to achieve precise immunotherapy and the development results of new drugs.