免疫检查点抑制剂联合放化疗在晚期非小细胞肺癌治疗中的研究进展

Progression of immune checkpoint inhibitors combined with chemoradiotherapy in the treatment of advanced non-small cell lung cancer

肺癌是目前全球发病率第二、死亡率最高的恶性肿瘤,大多数肺癌诊断时已无手术指征,放疗、化疗、靶向治疗和抗血管生成治疗是晚期非小细胞肺癌的主要治疗方法。近年来,随着肿瘤免疫治疗研究的深入,免疫检查点抑制剂[主要是程序性死亡受体-1/配体-L1(PD-1/PD-L1)阻断剂]在晚期非小细胞肺癌的治疗过程中取得了突破性的进步,然而能从免疫检查点抑制剂单药治疗中获益的人群比例不高。近期多项临床研究表明免疫检查点抑制剂联合放、化疗的治疗模式显著提高了晚期非小细胞肺癌患者的疗效,然而这一治疗模式的理论基础尚在不断深入研究中。本文主要探讨免疫检查点抑制剂联合放、化疗在晚期非小细胞肺癌治疗中的研究进展,以期更好地指导临床合理联合应用免疫检查点抑制剂和放化疗。

Lung cancer is one of the most common malignancies with the highest mortality in the world.Most lung cancers do not indicate surgery at the time of diagnosis.Radiotherapy,chemotherapy,targeted therapy,and anti-angiogenesis therapy are the main treatment methods for advanced non-small cell lung cancer(NSCLC).In recent years,with the development of tumor immunotherapy research,immune-checkpoint inhibitors[mainly programmed death receptor-1/ligand-L1(PD-1/PD-L1)blockers]have made breakthrough progress in the treatment of advanced NSCLC.However,the proportion of people who can benefit from single-drug treatment of immune checkpoint inhibitors is not high.Some recent clinical studies have shown that immune-checkpoint inhibitors combined with radiotherapy or chemotherapy significantly improve the efficacy of patients with advanced NSCLC.However,the theoretical basis of this combined treatment model is still under in-depth study.This review mainly discusses the research progress of immune-checkpoint inhibitors combined with radiotherapy or chemotherapy in the treatment of advanced NSCLC,to better guide the rational clinical application of immune-checkpoint inhibitors combined with radiotherapy or chemotherapy.