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小细胞肺癌免疫治疗的毒性

Toxicities of Immunotherapy for Small Cell Lung Cancer.

作者信息

Fu Yang, Zheng Yue, Wang Pei-Pei, Ding Zhen-Yu

机构信息

Department of Biotherapy, Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, China.

出版信息

Front Oncol. 2021 May 31;11:603658. doi: 10.3389/fonc.2021.603658. eCollection 2021.

Abstract

Small cell lung cancer (SCLC), composing 15-20% of lung cancer, is a fatal disease with extremely poor prognosis. In the past two decades, etoposide platinum doublet chemotherapy remained the only choice of therapy, with disappointing overall survival ≤1 year for the metastatic disease. Novel treatments including immunotherapy are urgently needed and extensively explored. Recently, in two phase III trials, atezolizumab and durvalumab were shown to bring survival benefit to patients. While immunotherapy brings better outcome, it is accompanied by adverse events different from traditional treatments. Although these immune-related adverse events (irAEs) are generally mild and can be managed, some irAEs (myocarditis, pneumonitis) may be severe and even life-threatening. Accompanying with the increasing application of immunotherapy in clinical practice, the irAEs should not be overlooked. In this review, the irAEs profile in clinical trials of immunotherapy for SCLC will be summarized, also its unique features compared with irAEs in other malignancies will be explored. This review may be helpful for the appropriate clinical use of immunotherapy for SCLC.

摘要

小细胞肺癌(SCLC)占肺癌的15%-20%,是一种预后极差的致命性疾病。在过去二十年中,依托泊苷联合铂类双药化疗一直是唯一的治疗选择,转移性疾病的总体生存率令人失望,≤1年。迫切需要并广泛探索包括免疫疗法在内的新型治疗方法。最近,在两项III期试验中,阿替利珠单抗和度伐利尤单抗被证明能给患者带来生存获益。虽然免疫疗法带来了更好的结果,但它伴随着与传统治疗不同的不良事件。尽管这些免疫相关不良事件(irAE)通常较轻且可以处理,但一些irAE(心肌炎、肺炎)可能很严重甚至危及生命。随着免疫疗法在临床实践中的应用日益增加,irAE不容忽视。在本综述中,将总结SCLC免疫疗法临床试验中的irAE概况,还将探讨其与其他恶性肿瘤中irAE相比的独特特征。本综述可能有助于SCLC免疫疗法的合理临床应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16ba/8200663/7280379eb63a/fonc-11-603658-g001.jpg

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