Department of Clinical and Molecular Sciences (DISCLIMO), Università Politecnica Delle Marche, Via Tronto 10/A, 60121 Ancona, Italy.
Clinic of Laboratory and Precision Medicine, National Institute of Health and Sciences on Ageing (IRCCS INRCA), 60124 Ancona, Italy.
Int J Mol Sci. 2023 Aug 9;24(16):12622. doi: 10.3390/ijms241612622.
Over the last decade, the therapeutic scenario for advanced non-small-cell lung cancer (NSCLC) has undergone a major paradigm shift. Immune checkpoint inhibitors (ICIs) have shown a meaningful clinical and survival improvement in different settings of the disease. However, the real benefit of this therapeutic approach remains controversial in selected NSCLC subsets, such as those of the elderly with active brain metastases or oncogene-addicted mutations. This is mainly due to the exclusion or underrepresentation of these patient subpopulations in most pivotal phase III studies; this precludes the generalization of ICI efficacy in this context. Moreover, no predictive biomarkers of ICI response exist that can help with patient selection for this therapeutic approach. Here, we critically summarize the current state of ICI efficacy in the most common "special" NSCLC subpopulations.
在过去的十年中，晚期非小细胞肺癌（NSCLC）的治疗格局发生了重大转变。免疫检查点抑制剂（ICI）在疾病的不同情况下显示出了有意义的临床和生存改善。然而，这种治疗方法的真正益处在某些 NSCLC 亚组中仍存在争议，例如伴有活动性脑转移或致癌基因依赖性突变的老年患者。这主要是由于大多数关键性 III 期研究中排除或代表性不足这些患者亚群；这使得无法在这种情况下推广 ICI 的疗效。此外，目前还没有预测 ICI 反应的生物标志物，可以帮助选择适合这种治疗方法的患者。在这里，我们批判性地总结了 ICI 在最常见的“特殊”NSCLC 亚群中的疗效现状。
