Marrone Kristen A, Brahmer Julie R
From the Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD.
Cancer J. 2016 Mar-Apr;22(2):81-91. doi: 10.1097/PPO.0000000000000178.
Lung cancer remains the number one cause of cancer death in the United States. Even with advances in understanding of tumor histology and mutation status, outcomes remain poor with classic cytotoxic therapies. The development of immune checkpoint inhibitors, designed to optimize a host's own immune response against cancer cells, has led to a new era in the treatment of non-small cell lung cancer (NSCLC). Improved survival in trials have led to rapid US Food and Drug Administration approval for these agents in the advanced-stage NSCLC setting. Many studies are looking at these agents across a variety of patient populations, treatment settings, and in combination with other agents. Because of their unique mechanism of action, tumor response kinetics and patient adverse effect profiles vary greatly from cytotoxic chemotherapy and demand further study. Understanding the optimal use of these agents continues to be elucidated as they shift the NSCLC treatment paradigm.
肺癌仍是美国癌症死亡的首要原因。即便在对肿瘤组织学和突变状态的认识方面取得了进展,但经典细胞毒性疗法的治疗效果依然不佳。旨在优化宿主自身针对癌细胞免疫反应的免疫检查点抑制剂的研发,开启了非小细胞肺癌(NSCLC)治疗的新纪元。试验中生存率的提高促使美国食品药品监督管理局迅速批准这些药物用于晚期NSCLC的治疗。许多研究正在针对不同患者群体、治疗环境以及与其他药物联合使用的情况对这些药物进行研究。由于其独特的作用机制,肿瘤反应动力学和患者不良反应特征与细胞毒性化疗有很大差异,需要进一步研究。随着这些药物改变NSCLC治疗模式,其最佳使用方法仍有待阐明。