Department of Oncology, Affiliated Dalian Third People's Hospital of Dalian Medical University, 116033, Dalian, China.
Br J Cancer. 2024 Feb;130(2):165-175. doi: 10.1038/s41416-023-02482-w. Epub 2023 Nov 9.
Nearly one-fifth of patients with non-small cell Lung Cancer (NSCLC) will develop liver metastases (LMs), and the overall treatment strategy of LMs will directly affect the survival of patients. However, some retrospective studies have found that patients receiving chemotherapy or targeted therapy have a poorer prognosis once LMs develop. In recent years, multiple randomised controlled trials (RCTS) have shown significant improvements in outcomes for patients with advanced lung cancer following the introduction of immune checkpoint inhibitors (ICIs) compared to conventional chemotherapy. ICIs is safe and effective in patients with LMs, although patients with LMs are mostly underrepresented in randomised clinical trials. However, NSCLC patients with LMs have a significantly worse prognosis than those without LMs when treated with ICIs, and the mechanism by which LMs induce systemic anti-tumour immunity reduction is unknown, so the management of LMs in patients with NSCLC is a clinical challenge that requires more optimised therapies to achieve effective disease control. In this review, we summarised the mechanism of ICIs in the treatment of LMs, the clinical research and treatment progress of ICIs and their combination with other therapies in patients with LMs from NSCLC.
近五分之一的非小细胞肺癌 (NSCLC) 患者将发展为肝转移 (LMs)，LMs 的总体治疗策略将直接影响患者的生存。然而，一些回顾性研究发现，一旦发生 LMs，接受化疗或靶向治疗的患者预后更差。近年来，多项随机对照试验 (RCTs) 表明，与传统化疗相比，免疫检查点抑制剂 (ICIs) 的引入显著改善了晚期肺癌患者的结局。ICI 对 LMs 患者是安全有效的，尽管 LMs 患者在随机临床试验中代表性不足。然而，与无 LMs 的患者相比，接受 ICI 治疗的 LMs 患者的预后明显更差，而 LMs 导致全身抗肿瘤免疫降低的机制尚不清楚，因此 NSCLC 患者 LMs 的管理是一个临床挑战，需要更优化的治疗方法来实现有效的疾病控制。在这篇综述中，我们总结了 ICI 治疗 LMs 的机制，以及 ICI 及其与其他疗法联合治疗 LMs 的 NSCLC 患者的临床研究和治疗进展。
