Vansteenkiste Johan, Wauters Els, Park Keunchil, Rittmeyer Achim, Sandler Alan, Spira Alexander
a Respiratory Oncology Unit, Department of Respiratory Medicine , University Hospitals KU Leuven , Leuven , Belgium.
b Division of Haematology-Oncology, Department of Medicine, Samsung Medical Centre , Sungkyunkwan University School of Medicine , Seoul , Republic of Korea.
Expert Opin Biol Ther. 2017 Jun;17(6):781-789. doi: 10.1080/14712598.2017.1309389. Epub 2017 Mar 28.
Immunotherapy has recently come to the forefront of oncology treatment as a potential means of combating cancer by restoring the body's adaptive cancer-immunity cycle. Atezolizumab is a monoclonal antibody agent that specifically targets programmed death ligand 1 (PD-L1), a key molecule in the cancer-immunity pathway, to block binding to its receptors PD-1 and B7.1. Areas covered: This review covers the role of atezolizumab in the treatment of non-small-cell lung cancer (NSCLC). Several studies have reported promising efficacy in this indication. The phase II FIR and BIRCH studies evaluated atezolizumab monotherapy across different lines of therapy in NSCLC selected by PD-L1 expression status. The randomized POPLAR and OAK trials of atezolizumab versus docetaxel in previously treated NSCLC reported improved efficacy in the atezolizumab arm. Several ongoing studies yet to report data are also described and treatment-related adverse events are discussed. Expert opinion: Clinical trials have shown that atezolizumab has a favorable risk-benefit ratio compared with standard chemotherapy in second-line treatment of non-oncogene-driven advanced NSCLC. Promising response rates and survival over 2 years has been reported in the first-line setting; however, more research is needed in this setting and in evaluating combinatorial strategies to treat NSCLC.
免疫疗法最近已成为肿瘤治疗的前沿手段，作为一种通过恢复机体适应性癌症免疫循环来对抗癌症的潜在方法。阿替利珠单抗是一种单克隆抗体药物，它特异性靶向程序性死亡配体1（PD-L1），这是癌症免疫途径中的关键分子，以阻断其与受体PD-1和B7.1的结合。涵盖领域：本综述涵盖了阿替利珠单抗在非小细胞肺癌（NSCLC）治疗中的作用。多项研究报告了该适应症的疗效令人鼓舞。II期FIR和BIRCH研究评估了阿替利珠单抗单药治疗在根据PD-L1表达状态选择的NSCLC不同治疗线中的疗效。阿替利珠单抗与多西他赛在既往治疗过的NSCLC中的随机化POPLAR和OAK试验报告阿替利珠单抗组疗效有所改善。还描述了几项尚未报告数据的正在进行的研究，并讨论了与治疗相关的不良事件。专家意见：临床试验表明，在非致癌基因驱动的晚期NSCLC二线治疗中，与标准化疗相比，阿替利珠单抗具有良好的风险效益比。在一线治疗中已报告了有前景的缓解率和超过2年的生存期；然而，在此治疗领域以及评估治疗NSCLC的联合策略方面仍需要更多研究。
