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美国临床肿瘤学会(ASCO)2020年非小细胞肺癌(NSCLC)个人亮点。

ASCO 2020 non-small lung cancer (NSCLC) personal highlights.

作者信息

Horvath Lena, Pircher Andreas

机构信息

Department of Hematology and Oncology, Internal Medicine V, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.

出版信息

Memo. 2021;14(1):66-69. doi: 10.1007/s12254-020-00673-2. Epub 2021 Jan 13.

Abstract

In this article we summarize our personal non-small cell lung cancer (NSCLC) highlights of the virtual ASCO 2020 meeting, covering developments in early and advanced-stage NSCLC. Until recently early stage NSCLC patients were treated independently of their genetic profile. Now the ADAURA study proved that postoperative osimertinib significantly prolongs disease-free survival compared to standard chemotherapy in EGFR-mutated NSCLC , underlining the high efficacy of targeted therapies in early stages. In advanced-stage disease, of course immunotherapy (IO) was at the center of attention. Final analysis of KEYNOTE-189 (pembrolizumab plus chemotherapy versus chemotherapy alone) and 3‑year update of CheckMate 227 (nivolumab plus ipilimumab versus standard chemotherapy) proved the long-term overall survival benefit of IO combinations in the first-line setting independent of PD-L1 status. The innovative CheckMate 9LA study demonstrated rapid disease control with limited-course chemotherapy plus IO doublet, while sparing chemotoxicity and may soon become a new clinical treatment choice. Moreover, the phase II CITYSCAPE trial presented significant response rates of the TIGIT-inhibitor tiragolumab plus atezolizumab in PD-L1 positive NSCLC. For HER2-mutated patients a highly effective drug conjugate trastuzumab deruxtecan was presented in a phase II study, extending targeted agents in genetically driven NSCLC. Altogether, ASCO 2020 could excite with inspiring new data for an optimized and more individualized NSCLC treatment regimen, contributing to a better outcome for both early and late-stage diseased patients and continuing to decrease lung cancer mortality.

摘要

在本文中,我们总结了2020年美国临床肿瘤学会(ASCO)虚拟会议上我们个人关注的非小细胞肺癌(NSCLC)亮点,涵盖早期和晚期NSCLC的进展。直到最近,早期NSCLC患者的治疗都与其基因特征无关。现在,ADAURA研究证明,在EGFR突变的NSCLC中,术后使用奥希替尼与标准化疗相比,能显著延长无病生存期,突显了靶向治疗在早期的高效性。在晚期疾病中,免疫疗法(IO)无疑是关注的焦点。KEYNOTE-189(帕博利珠单抗联合化疗与单纯化疗)的最终分析以及CheckMate 227(纳武利尤单抗联合伊匹木单抗与标准化疗)的3年更新数据证明,在一线治疗中,IO联合治疗无论PD-L1状态如何,都有长期的总生存获益。创新性的CheckMate 9LA研究表明,短疗程化疗联合IO双药方案能快速控制疾病,同时减少化疗毒性,可能很快成为一种新的临床治疗选择。此外,II期CITYSCAPE试验显示,在PD-L1阳性的NSCLC中,TIGIT抑制剂替雷戈珠单抗联合阿替利珠单抗有显著的缓解率。对于HER2突变的患者,一项II期研究展示了一种高效的药物偶联物曲妥珠单抗德鲁昔康,扩展了基因驱动的NSCLC中的靶向治疗药物。总之,2020年ASCO会议令人振奋的新数据为优化和更个体化的NSCLC治疗方案提供了依据,有助于改善早期和晚期患病患者的预后,并持续降低肺癌死亡率。

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