HER2阳性非小细胞肺癌临床治疗效果及安全性研究进展

Research Progress in Clinical Therapeutic Efficacy and Safety of HER2-Positive Non-Small Cell Lung Cancer

目的:肺癌作为一种常见的恶性肿瘤,是肿瘤患者死亡的主要原因之一。近年来,许多研究报道了靶向及免疫治疗在HER2阳性非小细胞肺癌(NSCLC)中的疗效。然而,目前仍然没有确切的方法应用于临床治疗中。方法:通过系统检索多个数据库,包括知网、万方、PubMed、Web of Science、Cochrane Library、Embase以及一些主要的肿瘤学会议,收集与HER2阳性NSCLC相关的临床试验,以了解各种治疗在HER2阳性NSCLC中的疗效。结果:系统分析发现在抗体药物偶联物(antibody-drug conju-gates, ADCs)、单克隆抗体、酪氨酸激酶抑制剂(tyrosine kinase inhibitors, TKIs)、免疫检查点抑制剂(immune checkpoint inhibitors, ICIs)等药物中,选择性TKIs及ADCs显示出了良好的抗肿瘤活性;单克隆抗体联合化疗取得了较好的结果;免疫治疗或免疫联合化疗作为一线治疗HER2阳性NSCLC也是一种有前景的干预措施。结论:选择性TKIs及ADCs是目前很有前景的HER2阳性NSCLC治疗药物,且具有可接受的安全性。

Objective: Lung cancer, as a common malignant tumor, is one of the major causes of death in tumor patients. In recent years, many studies have reported the efficacy of targeted and immunotherapy in HER2-positive non-small cell lung cancer (NSCLC). However, there is still no definitive method ap-plied in clinical treatment. Methods: We collected clinical trials related to HER2-positive NSCLC by systematically searching multiple databases, including CNKI, Wanfang, PubMed, Web of Science, Cochrane Library, Embase, and some major oncology conferences, to understand the efficacy of var-ious treatments in HER2-positive NSCLC. Results: Systematic analysis revealed that among anti-body-drug conjugates (ADCs), monoclonal antibodies, tyrosine kinase inhibitors (TKIs), and im-mune checkpoint inhibitors (ICIs), selective TKIs and ADCs showed good antitumor activity;mono-clonal antibodies in combination with chemotherapy yielded better results;and immunotherapy or immune-conjugated chemotherapy as a first-line treatment for HER2-positive NSCLC is also a prom-ising intervention. Conclusions: Selective TKIs and ADCs are currently promising agents for the treatment of HER2-positive NSCLC with an acceptable safety profile.