广泛期小细胞肺癌免疫治疗疗效预测和增敏策略

Effi cacy prediction and sensitization strategies for immunotherapy in extensive-stage small cell lung cancer

小细胞肺癌(small cell lung cancer,SCLC)约占肺癌诊断病例的15%。多数SCLC患者确诊即为广泛期,化疗是其首选治疗方案,但总体疗效有限,患者预后差,急需新的临床治疗方案。2019年以来以抗程序性死亡受体-1(programmed death-1,PD-1)/程序性死亡受体配体-1(programmed death ligand-1,PD-L1)抗体药物为代表的免疫检查点抑制剂显著改善广泛期SCLC患者的生存预后。美国食品药品管理局(Food and Drug Administration,FDA)批准免疫联合化疗成为广泛期SCLC临床免疫治疗新方案。然而,免疫联合治疗受益患者人群及治疗疗效有限,因此如何筛选潜在受益患者及进一步提高疗效是临床急需解决的问题。本文针对广泛期SCLC免疫治疗疗效预测生物标志物以及联合治疗增敏策略的研究进展进行综述。

Small cell lung cancer(SCLC)accounts for about 15%of all lung cancer cases.Most patients with SCLC are diagnosed with an extensive stage,and chemotherapy is their preferred treatment.However,the overall efficacy is limited and the prognosis of these patients is poor,so new approaches are urgently needed.Since 2019,immune checkpoint inhibitors,represented by anti-programmed death-1(PD-1)/programmed death ligand-1(PD-L1)antibody drugs,have significantly improved the survival prognosis of patients with extensive-stage SCLC.The United States Food and Drug Administration(FDA)approved immunotherapy combined with chemotherapy as a new clinical immunotherapy regimen for extensive-stage SCLC.However,the benefited population and therapeutic effect of combination immunotherapy are limited,so how to screen potentially benefited patients and further improve the therapeutic effect is an urgent clinical problem.In this paper,we reviewed the research progress in biomarkers for immunotherapy efficacy and sensitization strategies of combination therapies for extensive-stage SCLC.