a Thoracic Oncology Department , H. Lee Moffitt Cancer Center and Research Institute , Tampa , FL , USA.
Expert Opin Biol Ther. 2019 Mar;19(3):225-232. doi: 10.1080/14712598.2019.1571036. Epub 2019 Jan 25.
Immunotherapy, either as monotherapy or in combination with chemotherapy, has demonstrated superior efficacy to chemotherapy alone in the frontline setting. To date, there has been no randomized study comparing immunotherapy alone with chemo-immunotherapy.
This paper reviews the immunobiological rationale for combining chemotherapy with checkpoint inhibitors as well as the data from recent phase-3 studies to understand the risks and benefits associated with either therapeutic approach for diverse patient populations.
Frontline pembrolizumab monotherapy remains the treatment of choice for patients with high PD-L1 expression. For those with low PD-L1 expression, pembrolizumab in combination with chemotherapy can be considered.
免疫疗法，无论是单药治疗还是与化疗联合应用，在一线治疗中均显示出优于单纯化疗的疗效。迄今为止，尚无比较免疫单药治疗与化疗免疫联合治疗的随机研究。
本文综述了化疗联合检查点抑制剂的免疫生物学原理，以及来自最近的 3 期研究的数据，以了解对于不同患者群体，这两种治疗方法的风险和获益。
对于高 PD-L1 表达的患者，一线帕博利珠单抗单药治疗仍然是治疗的首选。对于 PD-L1 低表达的患者，可以考虑帕博利珠单抗联合化疗。
