Bloomberg-Kimmel Institute for Cancer Immunotherapy, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, United States.
Bloomberg-Kimmel Institute for Cancer Immunotherapy, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, United States.
Lung Cancer. 2023 Sep;183:107314. doi: 10.1016/j.lungcan.2023.107314. Epub 2023 Jul 28.
Only a minority of lung cancers are resectable at diagnosis, and many of these will eventually relapse. Adjuvant chemotherapy in this setting has a modest survival advantage, and there is significant need for new approaches to improve cure rates. Checkpoint inhibitor immunotherapy has transformed the prognosis for advanced lung cancer, and is increasingly being used in the neoadjuvant setting alone, or in combination with cytotoxic chemotherapy. While this has demonstrated convincing improvements in event-free survival and pathologic response, questions remain over optimal duration of therapy, predictive and prognostic biomarkers, response assessment and combination with other modalities. In addition, these results must be considered in the context of recent positive studies of adjuvant immunotherapy. Here, we summarise preclinical context and clinical trials in this space, discuss areas of controversy and pitfalls, and consider future challenges.
仅有少数肺癌患者在诊断时可进行切除，且其中许多患者最终会复发。辅助化疗在此情况下具有适度的生存优势，因此迫切需要新的方法来提高治愈率。检查点抑制剂免疫疗法改变了晚期肺癌的预后，并且越来越多地单独用于新辅助治疗，或者与细胞毒性化疗联合使用。虽然这已经证明在无事件生存期和病理缓解方面有明显改善，但关于最佳治疗持续时间、预测和预后生物标志物、反应评估以及与其他方式联合使用等问题仍存在疑问。此外，必须根据最近关于辅助免疫治疗的阳性研究来考虑这些结果。在这里，我们总结了这一领域的临床前背景和临床试验，讨论了有争议和易犯错误的地方，并考虑了未来的挑战。
