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晚期鳞状非小细胞肺癌治疗的突破:不再是被忽视的“兄弟”了?

Breakthroughs in the treatment of advanced squamous-cell NSCLC: not the neglected sibling anymore?

作者信息

Tsironis Georgios, Ziogas Dimitrios C, Kyriazoglou Anastasios, Lykka Marita, Koutsoukos Konstantinos, Bamias Aristotelis, Dimopoulos Meletios-Athanasios

机构信息

Department of Clinical Therapeutics, Alexandra General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.

出版信息

Ann Transl Med. 2018 Apr;6(8):143. doi: 10.21037/atm.2018.02.18.

Abstract

During the last years, translational research has contributed in many advances in the treatment of non-small cell lung cancer (NSCLC) discovering genetic alternations or recognizing the immuno-escape and neo-angiogenesis of lung cancer. Although the majority of these advances took place in the non-squamous histological subtype, therapeutic options for patients diagnosed with advanced squamous cell lung cancer (SqCLC) have been also enriched significantly with the addition of nab-paclitaxel in the conventional chemotherapy; the introduction of necitumumab, afatinib and erlotinib in the inhibition of epidermal growth factor receptor (EGFR) axis and of ramucirumab in the inhibition of VEGF-induced angiogenesis and last with the approvals of nivolumab, pembrolizumab atezolizumab and durvalumab soon in the promising field of immunotherapies. Agents targeted various other pathways including FGFR, IGF-1, PI3K, CDK4/6, MET and PARP inhibitors are under investigation in order to open new prospects in the treatment of SqCLC. In this review, we present all published data that led to recent approvals for the treatment of advanced SqCLC and all ongoing clinical trials that keep searching for new molecular targets following a more-personalized approach.

摘要

在过去几年中,转化研究在非小细胞肺癌(NSCLC)治疗方面取得了诸多进展,发现了基因改变,或认识到肺癌的免疫逃逸和新生血管生成。尽管这些进展大多发生在非鳞状组织学亚型中,但对于诊断为晚期鳞状细胞肺癌(SqCLC)的患者,随着在传统化疗中加入白蛋白结合型紫杉醇;在抑制表皮生长因子受体(EGFR)轴方面引入西妥昔单抗、阿法替尼和厄洛替尼,以及在抑制VEGF诱导的血管生成方面引入雷莫西尤单抗,最后随着纳武利尤单抗、帕博利珠单抗、阿特珠单抗和度伐利尤单抗在有前景的免疫治疗领域的相继获批,其治疗选择也得到了显著丰富。针对包括FGFR、IGF-1、PI3K、CDK4/6、MET和PARP抑制剂等各种其他途径的药物正在研究中,以便为SqCLC的治疗开辟新前景。在本综述中,我们展示了所有已发表的导致近期晚期SqCLC治疗获批的数据,以及所有正在进行的遵循更个性化方法寻找新分子靶点的临床试验。

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