Kim So Yeon, Halmos Balazs
Department of Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Lung Cancer Manag. 2020 Jul 24;9(3):LMT36. doi: 10.2217/lmt-2020-0003.
Combination platinum-based therapy has been the standard of care for the treatment of advanced non-small-cell lung cancer (NSCLC). Immunotherapy has emerged and demonstrated to show benefit in the treatment of patients with advanced NSCLC. In this review, we discuss the pivotal trials that led to the US FDA approval of specific immunotherapy regimens in particular patient populations. We discuss the optimal use of immunotherapy as monotherapy based on the KEYNOTE-024, KEYNOTE-042 and IMpower110 trials, chemo-immunotherapy based on KEYNOTE-189, KEYNOTE-407, IMpower150 and IMpower130 trials, and as doublet immunotherapy based on CheckMate-227. We also discuss the role and limitations of PD-L1 expression and tumor mutational burden as predictive biomarkers in response to single-agent immunotherapy and combination chemoimmunotherapy. Furthermore, we discuss emerging resistance markers such as and mutations in immunotherapy response and briefly discuss the role of immunotherapy in elderly patients and in patients with actionable mutations.
基于铂类的联合疗法一直是晚期非小细胞肺癌（NSCLC）治疗的标准疗法。免疫疗法已出现并被证明在晚期NSCLC患者的治疗中显示出益处。在本综述中，我们讨论了导致美国食品药品监督管理局（US FDA）批准特定免疫疗法方案用于特定患者群体的关键试验。我们基于KEYNOTE-024、KEYNOTE-042和IMpower110试验讨论了免疫疗法作为单一疗法的最佳使用，基于KEYNOTE-189、KEYNOTE-407、IMpower150和IMpower130试验讨论了化疗免疫疗法，以及基于CheckMate-227试验讨论了双联免疫疗法。我们还讨论了PD-L1表达和肿瘤突变负荷作为预测生物标志物在单药免疫疗法和联合化疗免疫疗法反应中的作用和局限性。此外，我们讨论了免疫疗法反应中如 和 突变等新兴的耐药标志物，并简要讨论了免疫疗法在老年患者和具有可操作突变患者中的作用。
