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纳武利尤单抗联合免疫治疗和/或化疗在晚期非小细胞肺癌一线治疗中的作用。

The role of nivolumab combined to immunotherapy and/or chemotherapy in the first-line treatment of advanced Non Small Cell Lung Cancer.

机构信息

Department of Pulmonary Oncology, AORN Dei Colli Monaldi, Naples, Italy.

Department of Experimental Medicine, Università Degli Studi Della Campania "Luigi Vanvitelli", Naples, Italy.

出版信息

Expert Opin Biol Ther. 2021 Mar;21(3):303-309. doi: 10.1080/14712598.2021.1869209. Epub 2020 Dec 31.

Abstract

: One of the latest breakthroughs in the treatment of advanced Non Small Cell Lung Cancer (NSCLC) is represented by PD-1/PD-L1-targeting Immune Checkpoint Inhibitors (ICIs). However, only a limited subset of advanced NSCLC patients can receive first-line ICI monotherapy (advanced NSCLC patients without driver mutations and with a PD-L1 expression ≥50% or ≥1%) and naïve ICI-respondent patients represent an even more limited subgroup of patients, which eventually experience progression of disease after approximately 7-11 months. Therefore, different strategies are being evaluated to obtain a higher response rate and a more durable clinical response in this setting. A very encouraging one is represented by ICI-combination therapies, i.e. the use of an ICI combined to cytotoxic chemotherapy and/or another immunotherapeutic agent.: This paper aims to assess currently available data from trials evaluating nivolumab-based first-line combination therapies.: Nivolumab-based combinations regimens will represent one of the standard treatments for naïve advanced NSCLC patients in a near future. However, in order to fully exploit these combination therapies, additional studies assessing potential predictive and/or prognostic biomarkers are required to better clarify which patients are more likely to benefit from these regimens, alongside with studies investigating safer and more durable second-line treatments.

摘要

: 针对晚期非小细胞肺癌(NSCLC)的治疗,最近的突破之一是 PD-1/PD-L1 靶向免疫检查点抑制剂(ICI)。然而,只有一小部分晚期 NSCLC 患者可以接受一线 ICI 单药治疗(无驱动基因突变且 PD-L1 表达≥50%或≥1%的晚期 NSCLC 患者),而 naive ICI-respondent 患者则是更为有限的患者亚组,他们最终在大约 7-11 个月后会出现疾病进展。因此,正在评估不同的策略以在这种情况下获得更高的反应率和更持久的临床反应。一种非常令人鼓舞的策略是 ICI 联合治疗,即使用 ICI 联合细胞毒性化疗和/或另一种免疫治疗药物。: 本文旨在评估目前评估纳武利尤单抗为基础的一线联合治疗试验中的可用数据。: 纳武利尤单抗为基础的联合治疗方案将在不久的将来成为 naïve 晚期 NSCLC 患者的标准治疗之一。然而,为了充分利用这些联合治疗,需要进行更多的研究来评估潜在的预测和/或预后生物标志物,以更好地阐明哪些患者更有可能从这些方案中受益,同时还需要研究更安全、更持久的二线治疗方法。

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