Li Shumin, Zhang Chengyan, Pang Guanchao, Wang Pingli
Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
Front Immunol. 2020 Oct 16;11:603157. doi: 10.3389/fimmu.2020.603157. eCollection 2020.
Immune checkpoint inhibitors (ICIs) have brought impressive clinical benefits in a variety of malignancies over the past years, which dramatically revolutionized the cancer treatment paradigm. Monotherapy or in combination with chemotherapy of ICIs targeting programmed death 1/programmed death ligand 1 (PD-L1) has emerged as an alternative treatment for patients with advanced non-small-cell lung cancer (NSCLC). However, constrained by primary or acquired resistance, most patients obtain limited benefits from ICIs and occasionally suffer from severe immune-related adverse events. Moreover, owing to the complexity of the tumor microenvironment and the technical limitations, clinical application of PD-L1 and tumor mutation burden as biomarkers shows many deficiencies. Thus, additional predictive biomarkers are required to further advance the precision of proper patient selection, avoiding the exposure of potential non-responders to unnecessary immunotoxicity. Nowadays, an increasing number of investigations are focusing on peripheral blood as a noninvasive alternative to tissue biopsy in predicting and monitoring treatment outcomes. Herein, we summarize the emerging blood-based biomarkers that could predict the clinical response to checkpoint immunotherapy, specifically in patients with NSCLC.
在过去几年中，免疫检查点抑制剂（ICIs）在多种恶性肿瘤中带来了令人瞩目的临床益处，极大地革新了癌症治疗模式。针对程序性死亡蛋白1/程序性死亡配体1（PD-L1）的ICIs单药治疗或与化疗联合治疗，已成为晚期非小细胞肺癌（NSCLC）患者的一种替代治疗方法。然而，受原发性或获得性耐药的限制，大多数患者从ICIs中获得的益处有限，且偶尔会遭受严重的免疫相关不良事件。此外，由于肿瘤微环境的复杂性和技术局限性，将PD-L1和肿瘤突变负荷作为生物标志物的临床应用存在许多不足。因此，需要额外的预测性生物标志物来进一步提高患者选择的准确性，避免潜在无反应者暴露于不必要的免疫毒性。如今，越来越多的研究将外周血作为组织活检的非侵入性替代方法，用于预测和监测治疗结果。在此，我们总结了新兴的基于血液的生物标志物，这些生物标志物可以预测对检查点免疫治疗的临床反应，特别是在NSCLC患者中。
