Wu Xinyu, Chau Yi Fung, Bai Hua, Zhuang Xiaofei, Wang Jie, Duan Jianchun
CAMS Key Laboratory of Translational Research on Lung Cancer, State Key Laboratory of Molecular Oncology, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences Peking Union Medical College, Beijing, China.
Department of Thoracic Surgery, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, China.
Front Oncol. 2023 Jan 24;12:1099304. doi: 10.3389/fonc.2022.1099304. eCollection 2022.
Immune checkpoint inhibitors (ICIs) are highly concerned in the treatment of non-small cell lung cancer (NSCLC), represented by inhibitors of programmed death protein 1 (PD-1) and its ligand (PD-L1), and inhibitors of cytotoxic T lymphocyte-associated antigen-4 (CTLA-4). The introduction of immunotherapy in the treatment of perioperative NSCLC has improved the prognosis to a great extent, as demonstrated by several phase II and III clinical trials. The target population for immunotherapy in early-stage NSCLC is still under discussion, and the biomarkers for neoadjuvant immunotherapy population selection are the next pending problem. The predictive efficacy of many potential makers is still being explored, including PD-L1 expression levels, tumor mutation burden, circulating tumor DNA, components of the tumor microenvironment, and several clinical factors. We summarize key findings on the utility of ICIs in clinical trials of preoperative NSCLC patients and conclude analyses of relevant biomarkers to provide a better understanding of potentially predictive biomarkers in neoadjuvant immunotherapy.
免疫检查点抑制剂(ICIs)在非小细胞肺癌(NSCLC)治疗中备受关注,以程序性死亡蛋白1(PD-1)及其配体(PD-L1)抑制剂以及细胞毒性T淋巴细胞相关抗原4(CTLA-4)抑制剂为代表。多项II期和III期临床试验表明,免疫疗法应用于围手术期NSCLC治疗极大地改善了预后。早期NSCLC免疫治疗的目标人群仍在讨论中,新辅助免疫治疗人群选择的生物标志物是下一个待解决的问题。许多潜在标志物的预测疗效仍在探索中,包括PD-L1表达水平、肿瘤突变负荷、循环肿瘤DNA、肿瘤微环境成分以及一些临床因素。我们总结了ICIs在术前NSCLC患者临床试验中的关键发现,并对相关生物标志物进行分析,以更好地理解新辅助免疫治疗中潜在的预测性生物标志物。