Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama 350-1298, Japan.
Medicina (Kaunas). 2021 Nov 19;57(11):1273. doi: 10.3390/medicina57111273.
Immune checkpoint inhibitors (ICIs) are standard treatments for patients with lung cancer. PD-1/PD-L1 or CTLA4 antibodies are chosen as the first-line therapy, contributing to the long-term survival and tolerability. Unlike molecular targeting agents, such as gefitinib, lung cancer patients with a poor performance status (PS) display unsatisfactory clinical improvements after ICI treatment. Several previous reports also demonstrated that the PS is identified as one of the most probable prognostic factors for predicting poor outcomes after ICI treatment. However, first-line pembrolizumab seemed to be effective for lung cancer patients with a PS of 2 if PD-L1 expression was greater than 50%. Currently, the induction of ICIs in patients with lung cancer with a poor PS is controversial. These problems are discussed in this review.
免疫检查点抑制剂（ICIs）是肺癌患者的标准治疗方法。PD-1/PD-L1 或 CTLA4 抗体被选为一线治疗药物，有助于长期生存和耐受性。与分子靶向药物（如吉非替尼）不同，免疫检查点抑制剂治疗后，身体状况较差（PS）的肺癌患者的临床改善并不令人满意。几项先前的报告还表明，PS 是预测免疫检查点抑制剂治疗后不良预后的最可能的预后因素之一。然而，如果 PD-L1 表达大于 50%，一线帕博利珠单抗似乎对 PS 为 2 的肺癌患者有效。目前，诱导身体状况较差的肺癌患者使用免疫检查点抑制剂存在争议。本文对这些问题进行了讨论。
