Giri Anshu, Walia Simrit S, Gajra Ajeet
Upstate University Hospital, Department of Medicine, 750 East Adams St, Syracuse, NY 13210, USA.
Rev Recent Clin Trials. 2016;11(4):297-305. doi: 10.2174/1574887111666160724181330.
Non-Small Cell Lung Cancer (NSCLC) is an aggressive malignancy with poor overall survival that accounts for up to 85% of lung cancer diagnoses. The use of immunotherapy in the form of checkpoint inhibition, to enhance the immune system's ability to attack malignant cells, has been a promising addition to treatment options in advanced NSCLC.
Such therapeutic agents aimed at the Programmed Death 1 (PD-1) receptor or Programmed Death Ligand 1 (PD-L1) have revealed promising results against many types of cancer including NSCLC. Examples of these agents include nivolumab, pembrolizumab, BMS-936559, atezolizumab, and MEDI4736, of which the first two are approved by US FDA in the second line treatment of advanced NSCLC.
Impressive improvements in objective responses from PD-1 blockade were found in both first line therapy as well as treatment after progression on platinum based therapy. In addition, the safety profile is favorable with significantly lower grade 3-4 adverse events compared to standard of care. The optimal selection criteria and factors that show an increased response to therapy are still being determined.
非小细胞肺癌（NSCLC）是一种侵袭性恶性肿瘤，总体生存率较低，占肺癌诊断病例的85%。以检查点抑制形式使用免疫疗法来增强免疫系统攻击恶性细胞的能力，已成为晚期NSCLC治疗选择中的一个有前景的补充。
针对程序性死亡1（PD-1）受体或程序性死亡配体1（PD-L1）的此类治疗药物在包括NSCLC在内的多种癌症类型中显示出有前景的结果。这些药物的例子包括纳武单抗、派姆单抗、BMS-936559、阿特珠单抗和MEDI4736，其中前两种已被美国食品药品监督管理局（US FDA）批准用于晚期NSCLC的二线治疗。
在一线治疗以及铂类治疗进展后的治疗中，均发现PD-1阻断在客观反应方面有显著改善。此外，安全性良好，与标准治疗相比，3-4级不良事件明显减少。仍在确定最佳选择标准以及显示对治疗反应增加的因素。
