脑转移瘤免疫相关疗效评价标准的研究进展

Ongoing Evaluation of Immune-related Response Assessment in Brain Metastases

脑转移瘤是成人恶性神经系统肿瘤最常见的病因。针对这一部分人群,治疗手段有限,预后不佳。近年来,以程序性死亡受体1(programmed cell death protein 1,PD-1)及程序性死亡受体配体1(programmed cell death protein ligand 1,PD-L1)抑制剂为主的免疫治疗,给恶性肿瘤的治疗模式带来了革新。免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)彻底改变了晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的治疗模式。ICI在某些驱动基因阴性的NSCLC脑转移瘤治疗中,取得了令人鼓舞的结果。然而,针对脑转移瘤患者的临床研究,不仅相应的临床数据有限,其疗效的评价也缺乏统一标准。本文旨在阐述不同的疗效评价标准及其在临床研究中的应用,比较之间的异同,并对未来发展趋势进行展望。

Brain metastases are the major cause of adult malignant nervous system tumors.For this part of population,treatment options are limited and the prognosis is poor.In recent years,immunotherapy based on inhibitors of programmed cell death protein 1(PD-1)and programmed cell death receptor ligand 1(PD-L1),have brought innovation to the treatment of malignant tumors.Immune checkpoint inhibitors(ICIs)have revolutionized the management of advanced nonsmall cell lung cancer(NSCLC).Encouraging results have suggested that ICIs could be active in selected advanced NSCLC brain metastases with driver-negative patients.However,for patients with brain metastases,not only the corresponding clinical data are limited,but also the evaluation of its efficacy lacks a unified standard.This article aims to review the relevant efficacy evaluation standards and their application in clinical researches,compare the similarities and differences,and look forward to future trends.