Hayashi Hidetoshi, Mitsudomi Tetsuya
Dept. of Medical Oncology, Kindai University, Faculty of Medicine.
Gan To Kagaku Ryoho. 2017 Sep;44(9):722-726.
Recent clinical evidence that anti-PD-1/PD-L1 antibody therapy is superior to cytotoxic chemotherapy for patients with non-small cell lung cancer(NSCLC)that expresses PD-L1 has lead to a paradigm shift in treatment strategies for those patients. However, efficacy of anti-PD-1/PD-L1 antibodies for patients with NSCLC harboring EGFR mutation is generally poor. This lack ofresponse is at least partially attributed to suppression oftumor infiltrating lymphocytes caused by EGFR pathway activation or to low non-synonymous mutation load in NSCLC with EGFR mutation. However, anti-PD-1/PD-L1 antibodies may play some roles in patients who acquired resistance against EGFR tyrosine kinase inhibitors. In this review, relationship between patients with EGFR mutation and treatment using immune-checkpoint inhibitors is summarized.
最近的临床证据表明，对于表达PD-L1的非小细胞肺癌（NSCLC）患者，抗PD-1/PD-L1抗体疗法优于细胞毒性化疗，这导致了这些患者治疗策略的范式转变。然而，抗PD-1/PD-L1抗体对携带EGFR突变的NSCLC患者的疗效通常较差。这种缺乏反应至少部分归因于EGFR通路激活导致的肿瘤浸润淋巴细胞抑制，或归因于EGFR突变的NSCLC中非同义突变负荷较低。然而，抗PD-1/PD-L1抗体可能在对EGFR酪氨酸激酶抑制剂产生耐药性的患者中发挥一定作用。在这篇综述中，总结了EGFR突变患者与使用免疫检查点抑制剂治疗之间的关系。
