Franzi Sara, Mattioni Giovanni, Rijavec Erika, Croci Giorgio Alberto, Tosi Davide
Thoracic Surgery and Lung Transplantation Unit, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
School of Thoracic Surgery, University of Milan, 20122 Milan, Italy.
J Clin Med. 2022 May 7;11(9):2629. doi: 10.3390/jcm11092629.
Non-small cell lung cancer accounts for approximately 80-85% of all lung cancers and at present represents the main cause of cancer death among both men and women. To date, surgery represents the cornerstone; nevertheless, around 40% of completely resected patients develop disease recurrence. Therefore, combining neoadjuvant chemo-immunotherapy and surgery might lead to improved survival. Immunotherapy is normally well tolerated, although significant adverse reactions have been reported in certain patients treated with inhibitors of immune checkpoints. In this review, we explore the current literature on the use of neoadjuvant chemo-immunotherapy followed by surgery for treatment of locally advanced non-small-cell lung cancer, with particular attention to the histological aspects, ongoing trials, and the most common surgical approaches. In conclusion, neoadjuvant immunotherapy whether combined or not with chemotherapy reveals a promising survival benefit for patients with advanced non-small-cell lung cancer; nevertheless, more data remain necessary to identify the best candidates for neoadjuvant regimens.
非小细胞肺癌约占所有肺癌的80-85%,目前是男性和女性癌症死亡的主要原因。迄今为止,手术是基石;然而,约40%完全切除的患者会出现疾病复发。因此,新辅助化疗联合免疫治疗与手术相结合可能会提高生存率。免疫治疗通常耐受性良好,尽管在某些接受免疫检查点抑制剂治疗的患者中报告了严重的不良反应。在本综述中,我们探讨了目前关于新辅助化疗联合免疫治疗后手术治疗局部晚期非小细胞肺癌的文献,特别关注组织学方面、正在进行的试验以及最常见的手术方法。总之,新辅助免疫治疗无论是否与化疗联合,都显示出对晚期非小细胞肺癌患者有希望的生存获益;然而,仍需要更多数据来确定新辅助治疗方案的最佳候选者。