From the Vanderbilt Ingram Cancer Center, Nashville, TN.
Cancer J. 2020 Nov/Dec;26(6):496-501. doi: 10.1097/PPO.0000000000000482.
Lung cancer is a leading cause of cancer-related mortality despite continued advances in diagnostic and therapeutic strategies. Although the development of immune checkpoint inhibitors has revolutionized the treatment landscape for advanced non-small cell lung cancer, many patients either have primary resistance to these agents or eventually develop secondary resistance necessitating a change to an alternate therapy. Understanding novel patterns of response to immunotherapy is crucial in determining appropriate selection and sequencing of treatment. Chemotherapy remains the standard of care in immunotherapy-refractory disease, but multiple trials are ongoing to explore the role of combination radioimmunotherapy and rechallenging with immunotherapy either alone or in combination with other antineoplastic agents.
尽管在诊断和治疗策略方面不断取得进展，但肺癌仍是癌症相关死亡的主要原因。尽管免疫检查点抑制剂的发展彻底改变了晚期非小细胞肺癌的治疗格局，但许多患者对这些药物要么存在原发性耐药，要么最终发生继发性耐药，需要改用其他治疗方法。了解免疫治疗的新反应模式对于确定治疗的适当选择和序贯至关重要。化疗仍然是免疫治疗耐药疾病的标准治疗方法，但正在进行多项试验以探索联合放免治疗以及单独或联合其他抗肿瘤药物再次免疫治疗的作用。
