Santini Fernando C, Hellmann Matthew D
Cancer J. 2018 Jan/Feb;24(1):15-19. doi: 10.1097/PPO.0000000000000300.
Cancer immunotherapies have revolutionized the treatment of non-small cell lung cancer. Yet, only a small subset of patients will benefit from PD-1 or PD-L1 blockade. PD-L1 tumor cell expression is the only approved biomarker at present. Tumor mutational burden and other emerging biomarkers should improve patient selection. Combination therapy approaches with chemotherapy or cytotoxic T-lymphocyte-associated protein 4 blockade may increase the proportion of patients who benefit from immunotherapy. Although use of immunotherapy in lung cancers with targetable oncogenes has not been particularly successful, the benefit of PD-(L)1 inhibitors in early-stage disease is emerging. This review briefly describes the evolution of the clinical development and future directions of PD-(L)1 blockade in patients with lung cancers.
癌症免疫疗法彻底改变了非小细胞肺癌的治疗方式。然而,只有一小部分患者能从PD-1或PD-L1阻断治疗中获益。目前,PD-L1肿瘤细胞表达是唯一获批的生物标志物。肿瘤突变负荷及其他新出现的生物标志物应能改善患者的选择。化疗或细胞毒性T淋巴细胞相关蛋白4阻断的联合治疗方法可能会增加从免疫疗法中获益的患者比例。虽然在具有可靶向致癌基因的肺癌中使用免疫疗法并非特别成功,但PD-(L)1抑制剂在早期疾病中的益处正在显现。本综述简要描述了肺癌患者中PD-(L)1阻断治疗的临床发展历程及未来方向。