围手术期免疫治疗非小细胞肺癌:新兴数据的实际应用和新挑战。

Perioperative Immunotherapy for Non-Small Cell Lung Cancer: Practical Application of Emerging Data and New Challenges.

机构信息

Department of Oncology, Montefiore Einstein Comprehensive Cancer Center, Albert Einstein College of Medicine, Bronx, NY.

Division of Thoracic Surgery and Surgical Oncology, Montefiore Einstein Comprehensive Cancer Center, Albert Einstein College of Medicine, Bronx, NY.

出版信息

Clin Lung Cancer. 2024 May;25(3):197-214. doi: 10.1016/j.cllc.2024.02.004. Epub 2024 Feb 13.

Abstract

Immune checkpoint inhibition, with or without chemotherapy, is an established standard of care for metastatic non-small cell lung cancer (NSCLC). For locally advanced NSCLC treated with chemoradiotherapy, consolidation immunotherapy has dramatically improved outcomes. Recently, immunotherapy has also been established as a valuable component of treatment for resectable NSCLC with pembrolizumab, atezolizumab, and nivolumab all approved for use in this setting. As more results read out from ongoing perioperative clinical trials, navigating treatment options will likely become increasingly complex for the practicing oncologist. In this paper, we distill key outcomes from major perioperative trials and highlight current knowledge gaps. In addition, we provide practical considerations for incorporating perioperative immunotherapy into the clinical management of operable NSCLC.

摘要

免疫检查点抑制,联合或不联合化疗,是转移性非小细胞肺癌(NSCLC)的既定标准治疗方法。对于接受放化疗的局部晚期 NSCLC,巩固免疫治疗显著改善了预后。最近,免疫疗法也已被确立为可切除 NSCLC 治疗的有效组成部分,帕博利珠单抗、阿替利珠单抗和纳武利尤单抗均被批准用于该治疗。随着正在进行的围手术期临床试验的更多结果读出,临床医生在选择治疗方案时可能会变得越来越复杂。在本文中,我们从主要围手术期试验中提取关键结果,并强调当前的知识空白。此外,我们还提供了将围手术期免疫治疗纳入可切除 NSCLC 临床管理的实用考虑因素。

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