Remon Jordi, Levy Antonin, Singh Pawan, Hendriks Lizza E L, Aldea Mihaela, Arrieta Oscar
Department of Medical Oncology, Centro Integral Oncológico Clara Campal (HM-CIOCC), Hospital HM Nou Delfos, HM Hospitales, Avinguda de Vallcarca, 151, Barcelona 08023, Spain.
Department of Radiation Oncology, International Center for Thoracic Cancers (CICT), Université Paris-Saclay, Gustave Roussy, Gustave Roussy, Villejuif, France.
Ther Adv Med Oncol. 2022 Jul 26;14:17588359221113268. doi: 10.1177/17588359221113268. eCollection 2022.
Consolidation anti-programmed death-ligand 1 has become a new standard of care in unresectable stage III non-small cell lung cancer (NSCLC) following chemo-radiotherapy (CTRT), based on the results of two phase III trials. Advances remain however needed, in particular to reduce the risk of distant relapse and for treatment personalization. Newer strategies are currently being tested, including consolidation with dual immune checkpoint inhibitors (ICIs), concurrent chemo-radioimmunotherapy and (chemo)-immunotherapy induction before CTRT. One randomized phase II reported better outcomes with a double ICI consolidation as compared with durvalumab alone. Three nonrandomized phase II trials also suggested that concurrent ICI-CTRT was feasible. Within this review, we summarize the current evidence, highlight ongoing trials and discuss challenges that will ideally lead to a cure for more patients with unresectable stage III NSCLC.
基于两项III期试验的结果，巩固性抗程序性死亡配体1已成为不可切除的III期非小细胞肺癌（NSCLC）放化疗（CTRT）后的新标准治疗方案。然而，仍需要取得进展，特别是降低远处复发风险和实现治疗个体化。目前正在测试更新的策略，包括使用双重免疫检查点抑制剂（ICI）进行巩固治疗、同步放化疗联合免疫治疗以及在CTRT前进行（化疗）免疫诱导治疗。一项随机II期试验报告称，与单独使用度伐鲁单抗相比，双重ICI巩固治疗的效果更好。三项非随机II期试验也表明同步ICI-CTRT是可行的。在本综述中，我们总结了当前的证据，突出了正在进行的试验，并讨论了有望使更多不可切除的III期NSCLC患者治愈的挑战。
