Department of Internal Medicine, Division of Medical Oncology, Suleyman Demirel University Faculty of Medicine, Isparta, Turkey.
Department of Internal Medicine, Division of Medical Oncology, Dr. A. Y. Ankara Oncology Training and Research Hospital, Ankara, Turkey.
Curr Probl Cancer. 2019 Feb;43(1):43-53. doi: 10.1016/j.currproblcancer.2018.07.008. Epub 2018 Aug 4.
Lung cancer is the most common cause of cancer death worldwide. Treatment for lung cancer has become increasingly more complex over the last several years. Immune checkpoint inhibitors have dramatically changed the treatment landscape of advanced nonsmall cell lung cancer (NSCLC). There are currently 3 approved checkpoint inhibitors for patients with NSCLC who progressed after platinum-doublet chemotherapy (Pembrolizumab and /or Nivolumab and /or Atezolizumab). Avelumab and durvalumab are currently under investigation in phase 3 trials. Pembrolizumab has now been approved for first-line use in NSCLC, after a trial showed improved survival compared with chemotherapy in patients who were positive for programmed cell death ligand 1. Giving our patients the best, personalized approach to their individual cancer can improve their quality of life and survival and help us use our limited resources most efficiently. In the present review, we provide a new patient-oriented algorithm to guide clinicians' decisions on the best choice of therapy for advanced NSCLC.
肺癌是全球最常见的癌症死因。近年来，肺癌的治疗变得越来越复杂。免疫检查点抑制剂极大地改变了晚期非小细胞肺癌（NSCLC）的治疗格局。目前，对于铂类双重化疗后进展的 NSCLC 患者，有 3 种批准的检查点抑制剂（Pembrolizumab 和/或 Nivolumab 和/或 Atezolizumab）。Avelumab 和 durvalumab 目前正在进行 3 期临床试验。在一项试验显示与化疗相比，在程序性细胞死亡配体 1 阳性的患者中，可改善生存率后，Pembrolizumab 现已获准用于 NSCLC 的一线治疗。为患者提供针对其个体癌症的最佳个性化方法，可以提高他们的生活质量和生存率，并帮助我们最有效地利用我们有限的资源。在本综述中，我们提供了一种新的以患者为导向的算法，以指导临床医生在晚期 NSCLC 治疗中做出最佳治疗选择的决策。
