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小细胞肺癌的靶向治疗和免疫治疗的机遇与挑战。

Opportunities and obstacles of targeted therapy and immunotherapy in small cell lung cancer.

机构信息

The Clinical Laboratory of Mianyang Central Hospital, Mianyang, China.

Collaborative Innovation Center for Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, China.

出版信息

J Drug Target. 2021 Jan;29(1):1-11. doi: 10.1080/1061186X.2020.1797050. Epub 2020 Jul 28.

Abstract

Small cell lung cancer (SCLC) is an aggressive malignant tumour which accounts for approximately 13-15% of all newly diagnosed lung cancer cases. To date, platinum-based chemotherapy are still the first-line treatments for SCLC. However, chemotherapy resistance and systemic toxicity limit the long-term clinical outcome of first-line treatment in SCLC. Recent years, targeted therapy and immunotherapy have made great breakthrough in cancer therapy, and researchers aim to exploit both as a single agent or in combination with chemotherapy to improve the survival of SCLC patients, but limited effectiveness and the adverse events remain the major obstacles in the treatment of SCLC. To overcome these challenges for SCLC therapies, prevention and early diagnosis for this refractory disease is very important. At the same time, we should reveal more information about the pathogenesis of SCLC and the mechanism of drug resistance. Finally, new treatment strategies should also be taken into considerations, such as repurposing drug, optimising of targets, combination therapy strategies or prognostic biomarkers to enhance therapeutic effects and decrease the adverse events rates in SCLC patients. This article will review the molecular biology characteristics of SCLC and discuss the opportunities and obstacles of the current therapy for SCLC patients.

摘要

小细胞肺癌(SCLC)是一种侵袭性恶性肿瘤,约占所有新诊断肺癌病例的 13-15%。迄今为止,铂类化疗仍然是 SCLC 的一线治疗方法。然而,化疗耐药和全身毒性限制了 SCLC 一线治疗的长期临床疗效。近年来,靶向治疗和免疫治疗在癌症治疗方面取得了重大突破,研究人员旨在将其作为单一药物或与化疗联合使用,以提高 SCLC 患者的生存率,但疗效有限和不良反应仍然是 SCLC 治疗的主要障碍。为了克服 SCLC 治疗的这些挑战,对这种难治性疾病进行预防和早期诊断非常重要。同时,我们应该揭示更多关于 SCLC 的发病机制和耐药机制的信息。最后,还应考虑新的治疗策略,如重新利用药物、优化靶点、联合治疗策略或预后生物标志物,以提高治疗效果并降低 SCLC 患者的不良反应发生率。本文将综述 SCLC 的分子生物学特征,并讨论当前 SCLC 患者治疗的机会和障碍。

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