识别免疫检查点抑制剂（ICI）治疗非小细胞肺癌（NSCLC）中的预后和预测生物标志物。
Recognizing Prognostic and Predictive Biomarkers in the Treatment of Non-Small Cell Lung Cancer (NSCLC) with Immune Checkpoint Inhibitors (ICIs).
作者信息
Giustini Nicholas, Bazhenova Lyudmila
机构信息
UCSD Moores Cancer Center, Department of Hematology and Oncology, 3855 Health Sciences Drive MC #0987, La Jolla, CA, 92093-0829, USA.
出版信息
Lung Cancer (Auckl). 2021 Mar 25;12:21-34. doi: 10.2147/LCTT.S235102. eCollection 2021.
Abstract
Immunotherapy plays a central role in the treatment of NSCLC and biomarkers predicting response to ICIs are valuable therapeutic tools. Programmed death-ligand 1 (PD-L1) immunohistochemistry (IHC) is integral in therapy selection as its positive predictive nature to ICIs in the metastatic setting is well documented. Tumor mutational burden (TMB) has undergone much study and, while results are somewhat mixed, there is evidence for its positive predictive value with ICI use. Additional markers such as tumor-infiltrating lymphocytes (TILs), gene expression profiling (GEP), mismatch repair (MMR) and microsatellite instability (MSI), somatic mutations, neutrophil to leukocyte ratio (NLR), smoking history, medication history, and immune-related adverse event (irAE) development can further guide clinicians.
摘要
免疫疗法在非小细胞肺癌（NSCLC）治疗中发挥着核心作用，预测免疫检查点抑制剂（ICI）反应的生物标志物是有价值的治疗工具。程序性死亡配体1（PD-L1）免疫组化（IHC）在治疗选择中不可或缺，因为其在转移性环境中对ICI的阳性预测特性已有充分记录。肿瘤突变负荷（TMB）已得到大量研究，虽然结果有些参差不齐，但有证据表明其在使用ICI时有阳性预测价值。其他标志物，如肿瘤浸润淋巴细胞（TILs）、基因表达谱（GEP）、错配修复（MMR）和微卫星不稳定性（MSI）、体细胞突变、中性粒细胞与白细胞比值（NLR）、吸烟史、用药史以及免疫相关不良事件（irAE）的发生情况，可进一步指导临床医生。
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