Liu Wei, Zhang Lei, Xiu Zhiming, Guo Jian, Wang Liye, Zhou Yue, Jiao Yang, Sun Meiyan, Cai Jianhui
College of Laboratory Medicine, Jilin Medical University, Jilin 132013, People's Republic of China.
Jilin Collaborative Innovation Center for Antibody Engineering, Jilin Medical University, Jilin 132013, People's Republic of China.
Onco Targets Ther. 2020 Jul 27;13:7229-7241. doi: 10.2147/OTT.S255491. eCollection 2020.
Tremendous progress has been achieved in the field of immune checkpoint inhibitors (ICIs) therapy in lung cancer in recent years. To generate robust, long-lasting anti-tumor immune responses in lung cancer patients, combinational ICI therapies have been explored deeply. Conventionally, chemotherapy was considered as immunosuppressive. It is now recognized that chemotherapy could also reinstate cancer cell immune-surveillance and enable the perception of cancer cells as dangerous. That is to say that chemotherapeutic drugs are not only a source of direct cytotoxic effects but also an adjuvant for anti-tumor immunity. Recently, multiple clinical studies of ICIs combined with chemotherapeutic drugs have been explored and proved effective. However, there are still crucial questions that are not well addressed, such as the optimal dose and schedule for a given combination may differ across disease indications, and the appropriate strategy of selecting patient population that can benefit from ICIs remains unclear. To facilitate more rational lung cancer ICIs therapy development, this review summarizes the immune-regulatory effects and related mechanisms of chemotherapeutic drugs and the clinical progress of ICIs and their combination with chemotherapies in lung cancer treatment.
近年来，免疫检查点抑制剂（ICI）治疗肺癌领域取得了巨大进展。为了在肺癌患者中产生强大、持久的抗肿瘤免疫反应，人们对联合ICI疗法进行了深入探索。传统上，化疗被认为具有免疫抑制作用。现在人们认识到，化疗也可以恢复癌细胞的免疫监视，并使机体将癌细胞视为危险信号。也就是说，化疗药物不仅是直接细胞毒性作用的来源，也是抗肿瘤免疫的佐剂。最近，多项ICI与化疗药物联合应用的临床研究已被探索并证明有效。然而，仍有一些关键问题尚未得到很好的解决，例如给定组合的最佳剂量和给药方案可能因疾病适应症而异，以及选择能够从ICI中获益的患者群体的合适策略仍不明确。为了促进更合理的肺癌ICI治疗发展，本综述总结了化疗药物的免疫调节作用及相关机制，以及ICI及其与化疗联合应用在肺癌治疗中的临床进展。
