Fitzpatrick Orla, Naidoo Jarushka
Department of Oncology, Beaumont Hospital, RCSI University of Health Sciences, Dublin, Ireland.
Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD, 21231, USA.
Lung Cancer (Auckl). 2021 Nov 2;12:123-131. doi: 10.2147/LCTT.S305466. eCollection 2021.
Immunocheckpoint inhibitors (ICIs) have altered the treatment landscape of a wide range of malignancies, including non-small cell lung cancer (NSCLC). This class of agents inhibits the interaction between PD1 and PDL1, and was shown to be efficacious in the landmark PACIFIC trial with 1 year of maintenance durvalumab (anti-PDL1 antibody). This trial demonstrated that its use as a consolidation treatment given after definitive chemoradiotherapy improved progression free survival and overall survival compared to standard-of-care treatment. In this review, we discuss both clinical trial and real-world data that have been published since PACIFIC that support the use of durvalumab for stage III unresectable NSCLC. In addition, we highlight specific populations that may require special considerations for the use of durvalumab in this setting, such as oncogene-addicted NSCLC, the toxicity of immunotherapy, and future directions in ICI research in stage III NSCLC.
免疫检查点抑制剂（ICIs）已经改变了包括非小细胞肺癌（NSCLC）在内的多种恶性肿瘤的治疗格局。这类药物可抑制PD1与PDL1之间的相互作用，并且在具有里程碑意义的PACIFIC试验中显示出疗效，该试验使用了1年的维持治疗度伐利尤单抗（抗PDL1抗体）。该试验表明，与标准治疗相比，在确定性放化疗后使用其作为巩固治疗可改善无进展生存期和总生存期。在本综述中，我们讨论了自PACIFIC试验以来已发表的支持度伐利尤单抗用于III期不可切除NSCLC的临床试验和真实世界数据。此外，我们强调了在这种情况下使用度伐利尤单抗可能需要特别考虑的特定人群，例如致癌基因成瘾的NSCLC、免疫疗法的毒性以及III期NSCLC中ICI研究的未来方向。
