Dumoulin Daphne W, Dingemans Anne-Marie C, Aerts Joachim G J V, Remon Jordi, De Ruysscher Dirk K M, Hendriks Lizza E L
Department of Pulmonary Medicine, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
Department of Respiratory Medicine, Maastricht University Medical Centre, GROW School for Oncology and Developmental Biology, Maastricht, The Netherlands.
Transl Lung Cancer Res. 2021 Jun;10(6):2970-2987. doi: 10.21037/tlcr-20-630.
Chemotherapy with or without radiotherapy has been the standard of care for many years for patients with small cell lung cancer (SCLC). Despite exceptionally high responses (up to 80%) with chemotherapy, the majority of patients relapse rapidly within weeks to months after treatment completion. Therefore, new and better treatment options are necessary. Recently, synergistic activity has been reported for the addition of immune checkpoint inhibitors (ICI) to standard platinum-based chemotherapy in the therapeutic strategy of advanced SCLC. For the first time after several decades, a significant survival improvement was achieved for this population. However, the overwhelming majority of patients do not respond to ICI, or relapse rapidly. There is need for better knowledge about the biology, histopathologic features, and molecular pathways of SCLC. This can probably help to identify the optimal predictive biomarkers, which are warranted to develop an individual therapeutic strategy including the rational use of a combination of immunotherapeutic agents. Here, we provide an overview of the rationale for and clinical results of the completed and ongoing trials using different strategies of immunotherapy in SCLC. In addition, opportunities for further improvement of therapies will be discussed, including the addition of radiotherapy, co-stimulatory antibodies, and other immune modifying agents.
多年来，对于小细胞肺癌（SCLC）患者，无论是否进行放疗，化疗一直是标准治疗方法。尽管化疗的缓解率极高（高达80%），但大多数患者在治疗结束后的数周或数月内迅速复发。因此，需要新的、更好的治疗选择。最近，在晚期SCLC的治疗策略中，已报道在标准铂类化疗中添加免疫检查点抑制剂（ICI）具有协同活性。几十年来首次，该人群的生存率有了显著提高。然而，绝大多数患者对ICI无反应或迅速复发。需要更好地了解SCLC的生物学、组织病理学特征和分子途径。这可能有助于识别最佳预测生物标志物，这些生物标志物对于制定包括合理使用免疫治疗药物组合的个体化治疗策略是必要的。在此，我们概述了在SCLC中使用不同免疫治疗策略的已完成和正在进行的试验的原理和临床结果。此外，还将讨论进一步改善治疗的机会，包括添加放疗、共刺激抗体和其他免疫调节剂。
