Luo Wenxin, Wang Zhoufeng, Zhang Ting, Yang Lan, Xian Jinghong, Li Yalun, Li Weimin
Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China.
Precision Medicine Research Center, West China Hospital, Sichuan University, Chengdu 610041, China.
Precis Clin Med. 2021 Dec 2;4(4):258-270. doi: 10.1093/pcmedi/pbab027. eCollection 2021 Dec.
Lung cancer, with non-small cell lung cancer (NSCLC) being the major type, is the second most common malignancy and the leading cause of cancer-related death globally. Immunotherapy, represented by immune checkpoint inhibitors (ICIs), has been one of the greatest advances in recent years for the treatment of solid tumors including NSCLC. However, not all NSCLC patients experience an effective response to immunotherapy with the established selection criteria of programmed death ligand 1 (PD-L1) and tumor mutational burden (TMB). Furthermore, a considerable proportion of patients experience unconventional responses, including pseudoprogression or hyperprogressive disease (HPD), immune-related toxicities, and primary or acquired resistance during the immunotherapy process. To better understand the immune response in NSCLC and provide reference for clinical decision-making, we herein review the rationale and recent advances in using immunotherapy to treat NSCLC. Moreover, we discuss the current challenges and future strategies of this approach to improve its efficacy and safety in treating NSCLC.
肺癌以非小细胞肺癌（NSCLC）为主，是全球第二大常见恶性肿瘤及癌症相关死亡的主要原因。以免疫检查点抑制剂（ICIs）为代表的免疫疗法是近年来实体瘤（包括NSCLC）治疗领域最重大的进展之一。然而，并非所有NSCLC患者都能在既定的程序性死亡配体1（PD-L1）和肿瘤突变负荷（TMB）选择标准下对免疫疗法产生有效反应。此外，相当一部分患者会出现非常规反应，包括假性进展或超进展性疾病（HPD）、免疫相关毒性以及免疫治疗过程中的原发性或获得性耐药。为了更好地理解NSCLC中的免疫反应并为临床决策提供参考，我们在此回顾使用免疫疗法治疗NSCLC的理论基础和最新进展。此外，我们还讨论了该方法目前面临的挑战以及未来策略，以提高其治疗NSCLC的疗效和安全性。
