Presented by Matthew A. Gubens, MD, MS, Division of Hematology/Oncology, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California.
J Natl Compr Canc Netw. 2017 May;15(5S):692-695. doi: 10.6004/jnccn.2017.0075.
In 2017, immunotherapy is the standard of care for patients with non-small cell lung cancer (NSCLC) either in the first or second line depending on programmed death ligand-1 (PD-L1) and mutation status. For first-line therapy, pembrolizumab is currently the standard of care for patients whose tumors express PD-L1 >50%. All patients with NSCLC should undergo PD-L1 testing before initiating treatment on pembrolizumab. For patients not eligible in the first line, immunotherapy is the standard of care for most in the second line. Nivolumab and atezolizumab are approved in all patients as second-line therapies after platinum-based doublet failure regardless PD-L1 expression level, although pembrolizumab is approved as second-line therapy for those whose tumors express PD-L1 >1%.
2017 年，免疫疗法是无论在一线还是二线治疗非小细胞肺癌（NSCLC）患者的标准治疗方案，这取决于程序性死亡配体-1（PD-L1）和基因突变状态。对于一线治疗，对于肿瘤 PD-L1 表达>50%的患者，目前帕博利珠单抗是标准治疗方案。所有 NSCLC 患者在开始帕博利珠单抗治疗前都应进行 PD-L1 检测。对于不符合一线治疗标准的患者，免疫疗法是大多数二线治疗的标准治疗方案。纳武利尤单抗和阿替利珠单抗在铂类双联化疗失败后，无论 PD-L1 表达水平如何，均可作为二线治疗方案批准用于所有患者，尽管帕博利珠单抗仅批准用于肿瘤 PD-L1 表达>1%的患者作为二线治疗方案。
