Vokes Natalie I, Pan Kelsey, Le Xiuning
Department of Thoracic Head and Neck Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA.
Department of Genomic Medicine, MD Anderson Cancer Center, Houston, TX, USA.
Ther Adv Med Oncol. 2023 Mar 18;15:17588359231161409. doi: 10.1177/17588359231161409. eCollection 2023.
For advanced metastatic non-small-lung cancer, the landscape of actionable driver alterations is rapidly growing, with nine targetable oncogenes and seven approvals within the last 5 years. This accelerated drug development has expanded the reach of targeted therapies, and it may soon be that a majority of patients with lung adenocarcinoma will be eligible for a targeted therapy during their treatment course. With these emerging therapeutic options, it is important to understand the existing data on immune checkpoint inhibitors (ICIs), along with their efficacy and safety for each oncogene-driven lung cancer, to best guide the selection and sequencing of various therapeutic options. This article reviews the clinical data on ICIs for each of the driver oncogene defined lung cancer subtypes, including efficacy, both for ICI as monotherapy or in combination with chemotherapy or radiation; toxicities from ICI/targeted therapy in combination or in sequence; and potential strategies to enhance ICI efficacy in oncogene-driven non-small-cell lung cancers.
对于晚期转移性非小细胞肺癌，可操作的驱动基因改变的情况正在迅速增加，在过去5年中有9种可靶向的致癌基因并获批了7种药物。这种加速的药物研发扩大了靶向治疗的范围，可能很快大多数肺腺癌患者在其治疗过程中将有资格接受靶向治疗。有了这些新出现的治疗选择，了解关于免疫检查点抑制剂（ICI）的现有数据，以及它们对每种致癌基因驱动的肺癌的疗效和安全性，对于最佳指导各种治疗选择的选择和排序非常重要。本文综述了针对每种驱动致癌基因定义的肺癌亚型的ICI临床数据，包括ICI单药治疗或与化疗或放疗联合使用的疗效；ICI/靶向治疗联合或序贯使用的毒性；以及提高致癌基因驱动的非小细胞肺癌中ICI疗效的潜在策略。
