Massafra Marco, Passalacqua Maria Ilenia, Gebbia Vittorio, Macrì Paolo, Lazzari Chiara, Gregorc Vanesa, Buda Carmelo, Altavilla Giuseppe, Santarpia Mariacarmela
Medical Oncology Unit, Department of Human Pathology "G. Barresi", University of Messina, Messina, Italy.
Medical Oncology and Supportive Care Unit, La Maddalena Cancer Center, Palermo, Italy.
Biologics. 2021 Oct 8;15:399-417. doi: 10.2147/BTT.S295406. eCollection 2021.
Immunotherapy with antibodies against PD-1 or PD-L1, either alone or in combination with chemotherapy, has revolutionized treatment paradigms of non-small cell lung cancer (NSCLC) patients without oncogenic driver alterations. These agents, namely immune checkpoint inhibitors (ICIs), have also widely demonstrated a remarkable efficacy in locally advanced as well as in early-stage NSCLC. Assessment of tumor PD-L1 expression by immunohistochemistry has entered into routine clinical practice to select patients for immunotherapy, even though its predictive role has long been debated. Despite improved survival outcomes over standard chemotherapy, treatment with ICIs is associated with initial low response rate, with a significant proportion of patients not responding to these agents. Hence, novel appealing predictive biomarkers, such as those related to tumor cell signaling pathways, metabolism or the tumor microenvironment, have emerged as potentially useful to select those patients most likely to benefit from immunotherapy. Moreover, most patients ultimately develop acquired resistance to ICI treatment over time and novel therapeutic strategies are urgently needed to overcome or delay resistance. Herein, we provide an overview on recent advances in immunotherapy in NSCLC, focusing on updated results from studies on ICIs in different disease settings and at different lines of treatment. We further describe currently emerging predictive biomarkers, beyond PD-L1, to optimize patient selection and novel strategies to improve clinical outcomes.
使用抗PD-1或PD-L1抗体进行免疫治疗,无论是单独使用还是与化疗联合使用,都彻底改变了无致癌驱动基因改变的非小细胞肺癌(NSCLC)患者的治疗模式。这些药物,即免疫检查点抑制剂(ICI),在局部晚期以及早期NSCLC中也广泛显示出显著疗效。通过免疫组织化学评估肿瘤PD-L1表达已进入常规临床实践,以选择接受免疫治疗的患者,尽管其预测作用长期以来一直存在争议。尽管与标准化疗相比生存结果有所改善,但ICI治疗的初始缓解率较低,有相当比例的患者对这些药物无反应。因此,新的有吸引力的预测生物标志物,如与肿瘤细胞信号通路、代谢或肿瘤微环境相关的生物标志物,已成为选择最有可能从免疫治疗中获益的患者的潜在有用指标。此外,大多数患者最终会随着时间的推移对ICI治疗产生获得性耐药,迫切需要新的治疗策略来克服或延缓耐药。在此,我们概述了NSCLC免疫治疗的最新进展,重点介绍了ICI在不同疾病阶段和不同治疗线的研究的最新结果。我们还进一步描述了目前除PD-L1之外正在出现的预测生物标志物,以优化患者选择,以及改善临床结果的新策略。
Biologics. 2021-10-8
Curr Treat Options Oncol. 2020-7-27
Aging (Albany NY). 2024-2-20
Cancers (Basel). 2023-1-19
Biologics. 2021-8-21
Transl Lung Cancer Res. 2021-6