Gatteschi Lavinia, Iannopollo Mauro, Gonfiotti Alessandro
Thoracic Surgery Unit, Cardiothoracic Department, University of Florence, 50100 Florence, Italy.
Oncology Unit, San Jacopo Hospital, Oncology Department, Central Tuscany AUSL, 51100 Pistoia, Italy.
Life (Basel). 2021 Oct 1;11(10):1036. doi: 10.3390/life11101036.
Lung cancer is one of the most common malignant tumors and it is the leading cause of cancer-related mortality worldwide. For early-stage Non-Small Cell Lung Cancer (NSCLC), surgical resection is the treatment of choice, but the 5-year survival is still unsatisfying, ranging from 60% to 36% depending on the disease stage. Multimodality treatment with adjuvant chemotherapy did not lead to clinically relevant results, improving survival rates by only 5%. Recently, immune checkpoint inhibitors (ICIs) are being studied as neoadjuvant treatment for resectable NSCLC too, after the satisfactory results obtained in stage IV disease. Several clinical trials are evaluating the safety and feasibility of neoadjuvant immunotherapy and their early findings suggest that ICIs could be better tolerated than standard neoadjuvant chemotherapy and more effective in reducing cancer local recurrence and metastasis. The aim of this review is to retrace the most relevant results of the completed and the ongoing clinical trials, in terms of efficacy and safety, but also to face the open challenges regarding ICIs in neoadjuvant setting for resectable NSCLC.
肺癌是最常见的恶性肿瘤之一，也是全球癌症相关死亡的主要原因。对于早期非小细胞肺癌（NSCLC），手术切除是首选治疗方法，但5年生存率仍不尽人意，根据疾病阶段不同，在60%至36%之间。辅助化疗的多模式治疗并未带来具有临床意义的结果，生存率仅提高了5%。最近，在IV期疾病取得令人满意的结果后，免疫检查点抑制剂（ICI）也正在作为可切除NSCLC的新辅助治疗进行研究。多项临床试验正在评估新辅助免疫治疗的安全性和可行性，其早期结果表明，ICI可能比标准新辅助化疗耐受性更好，在减少癌症局部复发和转移方面更有效。本综述的目的是回顾已完成和正在进行的临床试验在疗效和安全性方面最相关的结果，同时也应对可切除NSCLC新辅助治疗中ICI面临的未解决挑战。
