Department of Radiation Oncology, Hubei Cancer Hospital, TongJi Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China.
Front Immunol. 2024 Jan 12;14:1309055. doi: 10.3389/fimmu.2023.1309055. eCollection 2023.
Treatment of non-small-cell lung cancer (NSCLC) has entered the immunotherapy era, marked by significant survival improvements due to the use of immune checkpoint inhibitors (ICIs). However, owing to factors, such as disease progression, long-term use, and side effects, some patients discontinue immunotherapy, resulting in limited subsequent treatment option and a negative impact on their survival and quality of life. We have collected relevant data which reveal that ICI rechallenge may be an effective clinical strategy. However, many factors affect the efficacy of rechallenge, including patient characteristics, initial treatment drugs, treatment duration, efficacy, toxicity, and side effects. Additionally, the side effects of rechallenge and mechanisms of reversing drug resistance play crucial roles. Identifying suitable candidates, optimizing treatment plans and duration, enhancing treatment efficacy, and minimizing toxicity and adverse effects in rechallenges are pressing clinical needs. Addressing these issues can provide guidance for the clinical use of immunotherapy rechallenges to better serve patients. This review focuses on the clinical considerations and strategies for immune therapy rechallenges in NSCLC.
治疗非小细胞肺癌 (NSCLC) 已进入免疫治疗时代,由于免疫检查点抑制剂 (ICI) 的使用,患者的生存时间显著延长。然而,由于疾病进展、长期使用和副作用等因素,一些患者停止免疫治疗,导致后续治疗选择有限,对其生存和生活质量产生负面影响。我们收集了相关数据,表明 ICI 再挑战可能是一种有效的临床策略。然而,许多因素会影响再挑战的疗效,包括患者特征、初始治疗药物、治疗持续时间、疗效、毒性和副作用等。此外,再挑战的副作用和逆转耐药的机制也起着关键作用。确定合适的候选者、优化治疗方案和持续时间、提高治疗效果以及最小化再挑战的毒性和不良反应是紧迫的临床需求。解决这些问题可为免疫治疗再挑战的临床应用提供指导,以更好地为患者服务。本综述重点介绍 NSCLC 免疫治疗再挑战的临床考虑和策略。