驱动基因阴性晚期非小细胞肺癌最佳免疫治疗方案研究进展

Research Progress on the Optional Immunotherapy Regimen for Driver-negative Advanced Non-small Cell Lung Cancer

免疫治疗给驱动基因阴性晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的治疗带来划时代的变革,尤其是针对程序性死亡受体-1(PD-1)或程序性死亡配体-1(PD-L1)的免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)已成为一线治疗的基石。目前已被批准的免疫治疗方案包括免疫单药治疗、不同ICIs的联合治疗、免疫治疗联合化疗和免疫治疗联合化疗加抗血管治疗,但由于缺乏头对头的前瞻性比较,相关临床决策标准尚未确定。已有研究证实组织学亚型和肿瘤细胞的PD-L1表达程度对于治疗方案选择至关重要。此外,正在研究的几种新型生物标志物和治疗策略有望完善现有的治疗模式。全文针对驱动基因阴性的晚期NSCLC患者一线免疫治疗的研究进展作一综述。

Immunotherapy has brought about an epoch-making revolution in the treatment of drivernegative advanced non-small cell lung cancer(NSCLC).In particular,immune checkpoint inhibitors(ICIs)targeting PD-1 or PD-L1 have become the cornerstone of first-line therapy.At present the approved immunotherapeutic strategies include monotherapy,combination of different ICIs,immunotherapy combined chemotherapy,and immunotherapy combined chemotherapy plus antiangiogenic therapy.However,the criteria of corresponding clinical decision have not been established because of the absence of prospective comparisons among different strategies.Previous studies have demonstrated that histological subtype and the extent of PD-L1 expression in tumor cells were crucial for regimen selection.Furthermore,several novel biomarkers and therapeutic strategies are currently under investigation,which might refine the current treatment paradigm.In this review,we summarize the research progress on the first-line immunotherapy regimen for patients with driver-negative advanced NSCLC.