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非小细胞肺癌免疫治疗新场景下免疫检查点抑制剂的再治疗

Retreatment with Immune Checkpoint Inhibitors in the New Scenario of Immunotherapy in Non-Small Cell Lung Cancer.

作者信息

Rossi Sabrina, Masini Silvia, Finocchiaro Giovanna, Lorenzi Elena, Toschi Luca, Santoro Armando

机构信息

Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Via Alessandro Manzoni 56, Rozzano, 20089 Milan, Italy.

Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy.

出版信息

Cancers (Basel). 2024 Apr 26;16(9):1683. doi: 10.3390/cancers16091683.

Abstract

The advent of immunotherapy has transformed the treatment paradigm for metastatic non-small cell lung cancer (NSCLC). In the past few years, several studies have investigated the potential role of immune checkpoint inhibitors (ICIs) in resectable and unresectable locally advanced disease, achieving remarkable results that led to their approval in clinical practice. However, there is limited evidence on immunotherapy rechallenge after recurrence, with the majority of available knowledge coming from retrospective studies which involve heavily pretreated patients with advanced NSCLC. The recent introduction in the curative setting and the potential regulatory restrictions raise questions about the optimal choice of first-line and subsequent therapies for patients with systemic relapse. The role of immunotherapy readministration in this new scenario needs to be clarified, as well as the identification of patients for whom it is more appropriate, including clinical characteristics, duration of response, switching to other ICIs, reasons for discontinuation and immune-related toxicity. Here, we review literature on rechallenge with immunotherapy, including efficacy, safety profile and potential predictive factors of response.

摘要

免疫疗法的出现改变了转移性非小细胞肺癌(NSCLC)的治疗模式。在过去几年中,多项研究探讨了免疫检查点抑制剂(ICI)在可切除和不可切除的局部晚期疾病中的潜在作用,取得了显著成果,使其在临床实践中获得批准。然而,关于复发后免疫疗法再次挑战的证据有限,现有知识大多来自回顾性研究,这些研究涉及大量接受过重度治疗的晚期NSCLC患者。近期免疫疗法在根治性治疗中的应用以及潜在的监管限制,引发了关于系统性复发患者一线及后续治疗最佳选择的问题。在这种新情况下,免疫疗法重新给药的作用需要明确,以及确定更适合的患者,包括临床特征、缓解持续时间、换用其他ICI、停药原因和免疫相关毒性。在此,我们回顾了关于免疫疗法再次挑战的文献,包括疗效、安全性概况和潜在的反应预测因素。

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