双免疫检查点抑制剂联合治疗在非小细胞肺癌中的研究进展

Progression of dual immune checkpoint inhibitor combined therapy in non-small cell lung cancer

近年来,免疫检查点抑制剂广泛应用使得包括非小细胞肺癌(non-small cell lung cancer,NSCLC)在内的多种实体肿瘤的治疗模式发生了巨大变革,免疫检查点抑制剂(immune checkpoint inhibitor,ICI)在肿瘤治疗中的作用日益凸显,包括程序性死亡受体1(programmed cell death 1,PD-1)、程序性死亡配体1(programmed cell death ligand 1,PD-L1)、细胞毒性T淋巴细胞相关蛋白4(cytotoxic T lymphocyte-associated protein 4,CTLA-4)抗体在内的免疫药物,可以阻断效应T细胞上癌症来源的抑制信号,从而有效的清除残余的癌细胞及微小病灶,预防肿瘤的复发和转移。为了使更多患者受益,正在研究双免疫联合的治疗策略。本文旨在对双免疫联合治疗的机制、联合治疗模式、有效性及安全性进行综述。

Lung cancer is one of the most common malignant tumors in the world,and non-small cell lung cancer(NSCLC)accounts for 85%of lung cancer.Chemotherapy and targeted therapy significantly delay the progress of NSCLC,but inevitably appear drug resistance and relapse,and immunotherapy has brought a turnaround for some cancer patients.In the past 20 years or so,the role of immune checkpoint inhibitor(ICI)in tumor treatment has become increasingly prominent,including programmed cell death 1(PD-1),programmed cell death ligand 1(PD-L1),and cytotoxic T lymphocyte associated protein 4(CTLA-4)antibodies,can block cancer derived inhibitory signals on effector T cells,so as to effectively remove residual cancer cells and small lesions and prevent tumor recurrence and metastasis.In order to benefit more patients,combined immunotherapy strategies are being studied.The purpose of this paper is to review the mechanism,mode,efficacy and safety of dual immune combination therapy.