Department of Medicine, Oncology Division, Medical Oncology, Washington University School of Medicine in Saint Louis, St Louis, Missouri, USA.
Division of Hematology-Oncology, Department of Medicine, Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
J Immunother Cancer. 2022 May;10(5). doi: 10.1136/jitc-2021-003956.
Immunotherapy has transformed lung cancer care in recent years. In addition to providing durable responses and prolonged survival outcomes for a subset of patients with heavily pretreated non-small cell lung cancer (NSCLC), immune checkpoint inhibitors (ICIs)- either as monotherapy or in combination with other ICIs or chemotherapy-have demonstrated benefits in first-line therapy for advanced disease, the neoadjuvant and adjuvant settings, as well as in additional thoracic malignancies such as small-cell lung cancer (SCLC) and mesothelioma. Challenging questions remain, however, on topics including therapy selection, appropriate biomarker-based identification of patients who may derive benefit, the use of immunotherapy in special populations such as people with autoimmune disorders, and toxicity management. Patient and caregiver education and support for quality of life (QOL) is also important to attain maximal benefit with immunotherapy. To provide guidance to the oncology community on these and other important concerns, the Society for Immunotherapy of Cancer (SITC) convened a multidisciplinary panel of experts to develop a clinical practice guideline (CPG). This CPG represents an update to SITC's 2018 publication on immunotherapy for the treatment of NSCLC, and is expanded to include recommendations on SCLC and mesothelioma. The Expert Panel drew on the published literature as well as their clinical experience to develop recommendations for healthcare professionals on these important aspects of immunotherapeutic treatment for lung cancer and mesothelioma, including diagnostic testing, treatment planning, immune-related adverse events, and patient QOL considerations. The evidence- and consensus-based recommendations in this CPG are intended to give guidance to cancer care providers using immunotherapy to treat patients with lung cancer or mesothelioma.
免疫疗法近年来改变了肺癌的治疗方式。免疫检查点抑制剂(ICI)无论是单药治疗还是与其他 ICI 或化疗联合治疗,都为晚期疾病、新辅助和辅助治疗以及其他胸部恶性肿瘤(如小细胞肺癌[SCLC]和间皮瘤)的一线治疗提供了获益,为经过大量预处理的非小细胞肺癌(NSCLC)的一部分患者提供了持久的缓解和延长的生存结果。然而,在包括治疗选择、基于合适生物标志物确定可能获益的患者、免疫疗法在自身免疫性疾病等特殊人群中的应用以及毒性管理在内的挑战性问题上,仍存在疑问。患者和护理人员的教育以及对生活质量(QOL)的支持对于实现免疫治疗的最大获益也很重要。为了就这些问题和其他重要关注点为肿瘤学领域提供指导,癌症免疫治疗学会(SITC)召集了一个多学科专家小组制定了临床实践指南(CPG)。本 CPG 代表了 SITC 2018 年关于 NSCLC 免疫治疗的出版物的更新,并扩展到包括 SCLC 和间皮瘤的建议。专家组参考了已发表的文献和他们的临床经验,就免疫治疗肺癌和间皮瘤的重要方面为医疗保健专业人员制定了建议,包括诊断测试、治疗计划、免疫相关不良事件和患者 QOL 考虑因素。本 CPG 中的基于证据和共识的建议旨在为使用免疫疗法治疗肺癌或间皮瘤患者的癌症护理提供者提供指导。