Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA.
Department of Pharmacy, Baptist Health Lexington, Lexington, KY, USA.
Am J Health Syst Pharm. 2021 Apr 22;78(9):769-780. doi: 10.1093/ajhp/zxab041.
This article explores the efficacy, toxicity, place in therapy, and considerations for use of recently approved immune checkpoint inhibitors (ICIs) in the treatment of non-small cell lung cancer (NSCLC).
Lung cancer is the leading cause of cancer mortality in the United States and is responsible for more cancer-related deaths than breast, prostate, and colorectal cancer combined. The landscape for lung cancer treatment is evolving with the approval of new and exciting novel therapies. Within the last decade numerous ICIs have been approved for use in the management of the most common subtype of lung cancer, NSCLC. The ICI agents currently approved by the Food and Drug Administration (FDA) for use in NSCLC include ipilimumab, pembrolizumab, nivolumab, durvalumab, and atezolizumab. These agents are approved for specific indications; therefore, they are not interchangeable. This review focuses on the landmark trials that led to each FDA-approved indication, as well as common toxicities seen with use of these agents. It also discusses the use of ICIs in special populations and unique considerations prior to initiation of treatment with these novel therapies in a patient with NSCLC.
ICIs can provide a breakthrough treatment option for the management of NSCLC and are rapidly being adopted into clinical practice. It is important to be familiar with appropriate selection of an ICI therapy option for each patient based on approved indication, unique considerations, and anticipated toxicities.
本文探讨了最近批准的免疫检查点抑制剂（ICI）在非小细胞肺癌（NSCLC）治疗中的疗效、毒性、治疗地位和使用注意事项。
肺癌是美国癌症死亡的主要原因，其导致的癌症相关死亡人数超过乳腺癌、前列腺癌和结直肠癌死亡人数总和。随着新的令人兴奋的新型疗法的批准，肺癌治疗领域正在不断发展。在过去十年中，许多 ICI 已被批准用于治疗最常见的肺癌亚型 NSCLC。目前，食品和药物管理局（FDA）批准用于 NSCLC 的 ICI 药物包括伊匹单抗、帕博利珠单抗、纳武利尤单抗、度伐利尤单抗和阿替利珠单抗。这些药物有特定的适应证，因此不可互换。本综述重点介绍了每项 FDA 批准适应证的标志性试验，以及使用这些药物时常见的毒性反应。它还讨论了在开始使用这些新型疗法治疗 NSCLC 患者之前，ICI 在特殊人群中的应用和独特注意事项。
ICI 可为 NSCLC 的治疗提供突破性的治疗选择，并正在迅速被纳入临床实践。根据批准的适应证、独特的注意事项和预期的毒性反应，熟悉为每位患者选择合适的 ICI 治疗方案非常重要。
