糖皮质激素对非小细胞肺癌患者接受免疫检查点抑制剂的疗效影响

Effect of glucocorticoids on the efficacy of non-small cell lung cancer patients treated with immune-checkpoint inhibitors

肺癌目前是世界上及我国病死率最高的恶性肿瘤之一, 其中非小细胞肺癌(NSCLC)约占85%。近年来, 免疫检查点抑制剂(ICI)在肺癌治疗中取得了较大的进展, ICI单独使用或联合化疗是NSCLC的一线治疗方式。肺癌患者由于疾病本身、肿瘤并发症或免疫不良相关事件(irAE)需要使用糖皮质激素(GC)。GC作为一种具有免疫调节作用的物质, 是否会对NSCLC患者接受ICI的疗效产生影响目前尚存在争议。有研究认为使用GC不影响患者的生存时间, 而部分研究观点相反。了解GC对于免疫治疗的影响将有助于管理肿瘤患者的并发症, 治疗irAE等。本文就糖皮质激素对NSCLC患者接受ICI疗效的影响进行综述, 为临床治疗提供参考。

Lung cancer is a highly lethal malignant tumor worldwide and in China,with non-small cell lung cancer(NSCLC)accounting for approximately 85%of cases globally.In recent years,immune checkpoint inhibitor(ICI)had changed the paradigm of lung cancer treatment,either alone or in combination with chemotherapy and recomended as the first-line treatment for NSCLC.NSCLC patients often required glucocorticoid(GC)due to the cancer itself,tumor complications,or immune-related adverse event(irAE).GC had sparked debates on their impact on the therapeutic effectiveness of ICI in NSCLC patients as a substance with immunomodulatory effects.While some studies suggested that GC use did not influence patients survival,others argued the opposite.Understanding the effects of GC on immunotherapy is crucial for managing complaications in cancer patients and addressing irAE.This review explores the impact of GC on the efficacy of ICI in NSCLC patients,aiming to provide insights for clinical treatment.