Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Thorac Cancer. 2019 Apr;10(4):587-592. doi: 10.1111/1759-7714.13010. Epub 2019 Feb 19.
Immunotherapy has considerably changed the treatment of lung cancer. As immunotherapy has a special mechanism of action, the disease remission that it can induce is unique. Recently, Immune Response Evaluation Criteria in Solid Tumors (iRECIST), which focus on assessing the apparent curative effect of immunotherapy, have become widely accepted. Based on iRECIST criteria, if the response to immunotherapy is determined to be immunity-confirmed progressive disease or immunity-unconfirmed progressive disease, and the Eastern Cooperative Oncology Group score is worse than before treatment, immunotherapy should be discontinued. We report two immunity-confirmed progressive disease cases after pembrolizumab treatment and one immunity-unconfirmed progressive disease case after nivolumab treatment. All three patients benefited from continued immunotherapy, which indicates that the iRECIST criteria may have limitations in assessing the efficacy of immunotherapy for non-small cell lung cancer patients.
免疫疗法极大地改变了肺癌的治疗方式。由于免疫疗法具有特殊的作用机制，因此它能诱导的疾病缓解是独特的。最近，免疫治疗实体瘤反应评估标准（iRECIST）已被广泛接受，该标准侧重于评估免疫治疗的明显疗效。根据 iRECIST 标准，如果免疫治疗的反应被确定为免疫确认进展性疾病或免疫未确认进展性疾病，并且东部肿瘤协作组（ECOG）评分比治疗前更差，则应停止免疫治疗。我们报告了两例帕博利珠单抗治疗后免疫确认进展性疾病病例和一例纳武利尤单抗治疗后免疫未确认进展性疾病病例。所有三名患者均从继续免疫治疗中获益，这表明 iRECIST 标准在评估免疫疗法治疗非小细胞肺癌患者的疗效方面可能存在局限性。
