Division of Oncology, Washington University School of Medicine, St. Louis, Missouri.
Yale Comprehensive Cancer Center, Yale School of Medicine, New Haven, Connecticut.
Clin Cancer Res. 2016 Aug 1;22(15):3713-7. doi: 10.1158/1078-0432.CCR-15-2998. Epub 2016 Jun 1.
The outcomes for patients with previously treated advanced stage non-small lung cancer (NSCLC) are very poor, with a modest benefit from chemotherapy over best supportive care. Immunotherapy offers a novel approach for the treatment of these patients, with two anti-programmed death 1 (PD-1) checkpoint inhibitors, nivolumab and pembrolizumab, recently approved by the FDA based on large randomized clinical trials showing increased overall survival compared with standard second-line docetaxel. Although only a subset of patients benefit from these drugs, the treatment is usually well tolerated and the responses are often durable, with an unprecedented number of survivors 3 years after starting the therapy. The next steps should be the identification of reliable predictors for benefit from immunotherapy with checkpoint inhibitors and the pursuit of well-designed combination therapies. In this article, we review the rationale for the use of checkpoint inhibitors in NSCLC, the data from phase I and randomized clinical trials, and future directions. Clin Cancer Res; 22(15); 3713-7. ©2016 AACR.
先前接受治疗的晚期非小细胞肺癌(NSCLC)患者的预后非常差,化疗相对于最佳支持治疗仅有适度获益。免疫疗法为这些患者的治疗提供了一种新方法,两种抗程序性死亡 1(PD-1)检查点抑制剂,纳武单抗和派姆单抗,最近基于大型随机临床试验结果获得了 FDA 的批准,这些试验显示与标准二线多西他赛相比,总生存期有所提高。尽管只有一部分患者从这些药物中获益,但该治疗通常具有良好的耐受性,且反应往往持久,开始治疗 3 年后出现了数量空前的幸存者。下一步应该是确定免疫检查点抑制剂治疗获益的可靠预测因素,并追求精心设计的联合治疗。本文综述了在 NSCLC 中使用检查点抑制剂的原理、I 期和随机临床试验的数据,以及未来的方向。临床癌症研究;22(15);3713-7。©2016AACR。