摘要
广泛期小细胞肺癌(extensive-stage small cell lung cancer,ES-SCLC)是一种预后不良的高度恶性疾病,在过去的几十年里,尽管有许多关于新化学疗法及其组合和新生物制剂的临床试验不断开展,但总生存率一直止步不前,含铂类药物的EP/EC化疗方案一直是ES-SCLC的标准治疗模式,然而化疗的效果不尽如人意,中位生存时间和2年生存率分别只有7~10个月和10%~20%。近年来关于ES-SCLC的免疫联合疗法有了新的进展,打破了以往的治疗瓶颈。ES-SCLC的全基因组分析显示,大多数ES-SCLC患者p53(90%)和Rb1(65%)基因失活,这些基因突变导致了基因组的不稳定性,使肿瘤产生持久的相关抗原,使得ES-SCLC具有较高的突变负荷,从而奠定了免疫治疗的基础。回顾和分析最近的文献,讨论免疫联合化疗、免疫联合放疗、免疫联合免疫、免疫联合抗血管治疗ES-SCLC方案和正在进行的临床试验,此外就目前ESSCLC免疫联合治疗模式的探索进行综述。
Extensive-stage small cell lung cancer(ES-SCLC)is a highly malignant disease with a poor prognosis.In the past few decades,although many clinical trials on new chemotherapy with its combinations and new biological agents were conducted,the overall survival rate has never been improved.The platinum-containing EP/EC chemotherapy regimen has always been the standard treatment method for ES-SCLC,however,the results of chemotherapy are not satisfactory,the median survival time and 2-year survival rate are only 7-10 months and 10%-20%,respectively.In recent years,there have been new advances in the combined immunotherapy for ES-SCLC,breaking the previous treatment bottleneck.The comprehensive genomic analysis of ES-SCLC shows that p53(90%)and Rb1(65%)are inactivated in most ES-SCLC patients.These gene mutations lead to the instability of the genome,causing ES-SCLC to have a high mutation load due to production of persistent related antigens by the tumor,thus laying the foundation for immunotherapy.We reviewed and analyzed the recent literature and discussed the combined immunotherapy regimens of ES-SCLC and ongoing clinical trials.We also reviewed the current exploration of combined immunotherapy model for ES-SCLC.
作者
李国雨
何明
LI Guoyu;HE Ming(Graduate School of Hebei Medical University,Shijiazhuang 050011,Hebei Province,China;Department of Thoracic Surgery,the Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,Hebei Province,China)
出处
《中国癌症杂志》
CAS
CSCD
北大核心
2020年第10期826-833,共8页
China Oncology
关键词
广泛期小细胞肺癌
免疫药物
免疫联合治疗
临床试验。
Extensive-stage small cell lung cancer
Immunologic drugs
Combined immunotherapy
Clinical trials