Fang Likui, Zhao Wuchen, Ye Bo, Chen Da
Department of Thoracic Surgery, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Front Oncol. 2021 May 4;11:670313. doi: 10.3389/fonc.2021.670313. eCollection 2021.
Brain metastases remain a critical issue in the management of non-small cell lung cancer (NSCLC) because of the high frequency and poor prognosis, with survival rates often measured in just months. The local treatment approach remains the current standard of care, but management of multiple asymptomatic brain metastases always involves systemic therapy. Given that anti-angiogenic agents and immune checkpoint inhibitors (ICIs) both target the tumor microenvironment (TME), this combination therapy has become a promising strategy in clinical practice. Increasing number of preclinical and clinical studies have shown remarkable anti-tumor activity of the combination therapy, but the efficacy in brain metastases is unclear due to the strict selection criteria adopted in most clinical trials. This review briefly summarizes the potential synergistic anti-tumor effect and clinical development of the combination of anti-angiogenic agents and ICIs in NSCLC brain metastases, and discusses the existing challenges and problems.
脑转移瘤仍然是非小细胞肺癌（NSCLC）治疗中的一个关键问题，因为其发生率高且预后较差，生存率通常仅以数月计算。局部治疗方法仍是当前的标准治疗方案，但对于多个无症状脑转移瘤的管理始终涉及全身治疗。鉴于抗血管生成药物和免疫检查点抑制剂（ICI）均作用于肿瘤微环境（TME），这种联合治疗已成为临床实践中一种有前景的策略。越来越多的临床前和临床研究表明联合治疗具有显著的抗肿瘤活性，但由于大多数临床试验采用严格的选择标准，其对脑转移瘤的疗效尚不清楚。本综述简要总结了抗血管生成药物与ICI联合治疗NSCLC脑转移瘤的潜在协同抗肿瘤作用及临床进展，并讨论了现存的挑战和问题。
