Department of Thoracic Oncology, Tianjin Cancer Hospital Airport Hospital, National Clinical Research Center for Cancer, Tianjin, China.
Department of Pulmonary Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China.
Thorac Cancer. 2022 Nov;13(22):3208-3216. doi: 10.1111/1759-7714.14679. Epub 2022 Oct 8.
Immunotherapy has been proved to have a large effect on extensive-stage small cell lung cancer, but the role of immunotherapy in limited-stage small-cell lung cancer (LS-SCLC) is still unknown.
A retrospective study of six patients with LS-SCLC who were treated with neoadjuvant chemoimmunotherapy (durvalumab plus etoposide combined with cisplatin) was performed. Patients were evaluated by the safety, feasibility and pathologic responses of neoadjuvant chemoimmunotherapy.
Neoadjuvant durvalumab combined chemotherapy was associated with few immediate adverse events and did not delay planned surgery. All patients achieved partial pathologic response (pPR) instead of major pathologic response, or pathologic complete response. No association was observed between programmed death-ligand 1 expression in tumor specimens and the pathologic response. However, tumors with high expression of immune cells such as CD4+ T cells, CD8+ T cells and FoxP3+ Tregs tended to have better pathologic responses than tumors with low expression of immune cells.
Neoadjuvant durvalumab combined chemotherapy could induce pPR with few side effects in resectable LS-SCLC. The immune cells in the tumor microenvironment might play an important role in neoadjuvant chemoimmunotherapy in resectable LS-SCLC.
免疫疗法已被证明对广泛期小细胞肺癌有显著疗效，但免疫疗法在局限期小细胞肺癌（LS-SCLC）中的作用仍不清楚。
对 6 例接受新辅助化疗免疫治疗（度伐利尤单抗联合依托泊苷联合顺铂）的 LS-SCLC 患者进行了回顾性研究。通过新辅助化疗免疫治疗的安全性、可行性和病理反应评估患者。
新辅助度伐利尤单抗联合化疗与较少的即刻不良事件相关，且不延迟计划的手术。所有患者均获得部分病理缓解（pPR）而非主要病理缓解或病理完全缓解。肿瘤标本中程序性死亡配体 1 的表达与病理反应之间无相关性。然而，与免疫细胞表达较低的肿瘤相比，高表达免疫细胞（如 CD4+T 细胞、CD8+T 细胞和 FoxP3+Tregs）的肿瘤更倾向于获得更好的病理缓解。
新辅助度伐利尤单抗联合化疗可诱导可切除 LS-SCLC 获得 pPR，且副作用较少。肿瘤微环境中的免疫细胞可能在可切除 LS-SCLC 的新辅助化疗免疫治疗中发挥重要作用。
