Loh Jerold, Low Jia Li, Sachdeva Manavi, Low Peter Qj, Wong Rachel Su Jen, Huang Yiqing, Chia Puey Ling, Soo Ross A
Department of Haematology-Oncology, National University Cancer Institute, Singapore (NCIS), National University Health System, Singapore, Singapore.
Department of Medical Oncology, Tan Tock Seng Hospital, Singapore, Singapore.
Expert Rev Anticancer Ther. 2023 Jul-Dec;23(9):913-926. doi: 10.1080/14737140.2023.2245140. Epub 2023 Aug 13.
The current standard of care of locally advanced non-small cell lung cancer (LA-NSCLC) is concurrent chemoradiation, followed by consolidation durvalumab. However, there is evidence that the efficacy of chemoradiation and also immunotherapy in many oncogene-positive LA-NSCLC are attenuated, and dependent on the subgroup.
We will firstly review the outcomes of standard-of-care therapy in oncogene-driven LA-NSCLC. We looked at various oncogene driven subgroups and the tumor microenvironment that may explain differential response. Finally, we review the role of targeted therapy in the treatment of LA-NSCLC.
Each oncogene-positive subgroup should be treated as its own entity, and continued efforts should be undertaken to incorporate targeted therapy, which is likely to yield superior survival outcomes if trial design can be optimized and toxicities can be managed.
局部晚期非小细胞肺癌（LA-NSCLC）目前的标准治疗方案是同步放化疗，随后使用度伐利尤单抗进行巩固治疗。然而，有证据表明，在许多致癌基因阳性的LA-NSCLC中，放化疗以及免疫疗法的疗效会减弱，且取决于亚组情况。
我们将首先回顾致癌基因驱动的LA-NSCLC的标准治疗方案的结果。我们研究了各种致癌基因驱动的亚组以及可能解释不同反应的肿瘤微环境。最后，我们回顾了靶向治疗在LA-NSCLC治疗中的作用。
每个致癌基因阳性亚组都应作为独立个体进行治疗，并且应持续努力纳入靶向治疗，如果试验设计能够优化且毒性能够得到控制，靶向治疗可能会带来更好的生存结果。
