Centro Integral Oncología Clara Campal Bacelona, HM-Delfos, Medical Oncology Department, Barcelona, Spain.
Gustave Roussy, Cancer Medicine Department, Villejuif, France; Maastricht University Medical Center+, Pulmonary Diseases Department, GROW - School for Oncology and Developmental Biology, Maastricht, the Netherlands.
Cancer Treat Rev. 2018 Dec;71:47-58. doi: 10.1016/j.ctrv.2018.10.006. Epub 2018 Oct 15.
Immune checkpoint inhibitors (ICIs) have been incorporated in the treatment strategy of advanced non-small cell lung cancer (NSCLC) in first- and second-line setting improving the prognosis of these patients. However, the treatment landscape has been also drastically overturned with the advent of targeted therapies in oncogenic-addicted advanced NSCLC patients. Despite ICIs represent an active and new treatment option for a wide range of advanced NSCLC patients, the efficacy and the optimal place of ICI in the treatment strategy algorithm of oncogenic-addicted tumors remains still controversial, as only a minority of trials with ICI enrol oncogenic-addicted NSCLC patients previously treated with standard therapy. Therefore, there are still several open questions about ICI in oncogenic-driven NSCLC, such as the efficacy and toxicities, which need to be addressed before considering treatment with ICI as a standard approach in this population. It is in this framework, we provide a thorough overview on this currently controversial topic.
免疫检查点抑制剂 (ICIs) 已被纳入晚期非小细胞肺癌 (NSCLC) 的一线和二线治疗策略中，改善了这些患者的预后。然而，随着针对致癌基因依赖的晚期 NSCLC 患者的靶向治疗的出现，治疗格局也发生了巨大变化。尽管 ICI 代表了广泛的晚期 NSCLC 患者的一种积极和新的治疗选择，但 ICI 在致癌基因依赖肿瘤治疗策略算法中的疗效和最佳位置仍然存在争议，因为只有少数试验招募了先前接受标准治疗的致癌基因依赖 NSCLC 患者。因此，关于致癌驱动的 NSCLC 中的 ICI，仍有几个尚未解决的问题，例如疗效和毒性，在考虑将 ICI 作为该人群的标准治疗方法之前，需要解决这些问题。正是在这个框架内，我们对这个目前存在争议的话题进行了全面的概述。
