Ostoros Gyula
Országos Korányi Pulmonológiai Intézet, Budakeszi, Hungary.
Magy Onkol. 2020 Sep 23;64(3):217-223. Epub 2020 Aug 5.
Immune checkpoint inhibitor therapy in lung cancer is a new effective treatment as part of a complex treatment strategy. In the advanced stage of non-small cell non-squamous lung cancer, without actionable mutation, the immune monotherapy or combination treatment with platinum based chemotherapy is a new standard of care depending on PD-L1 status. In case of advanced squamous cell lung cancer the situation is similar. The exact role of combination PD-1 axis and CTLA-4 inhibitor treatment with or without chemotherapy is not exactly defined. Immune checkpoint inhibitor therapy can be used in second or more line treatment as well. After exhaustion of targeted treatment the efficacy of the combination of immunotherapy with angiogenesis inhibitor and platinum based chemotherapy is promising. In locally advanced non-small cell lung cancer after radiochemotherapy the consolidation PD-L1 inhibitor treatment is a new standard of care in case of PD-L1 positivity. There are Phase III trials in neoadjuvant and adjuvant setting as well. In extensive stage small cell lung cancer the platinum-etoposide treatment with PD-L1 inhibitor is a new standard, but we do not have any effective biomarkers yet.
免疫检查点抑制剂疗法作为复杂治疗策略的一部分，是肺癌治疗中的一种新型有效疗法。在无驱动突变的晚期非小细胞非鳞癌中，根据PD-L1状态，免疫单药治疗或与铂类化疗联合治疗是新的标准治疗方案。在晚期肺鳞癌中情况类似。PD-1轴与CTLA-4抑制剂联合治疗（无论是否联合化疗）的确切作用尚未完全明确。免疫检查点抑制剂疗法也可用于二线及以上治疗。在靶向治疗无效后，免疫疗法与血管生成抑制剂及铂类化疗联合使用的疗效很有前景。在局部晚期非小细胞肺癌放化疗后，对于PD-L1阳性患者，巩固性PD-L1抑制剂治疗是新的标准治疗方案。新辅助和辅助治疗也有III期试验。在广泛期小细胞肺癌中，铂类-依托泊苷联合PD-L1抑制剂治疗是新的标准，但我们尚未有任何有效的生物标志物。
