Le Uyen-Thao, Ohm Birte, Schmid Severin
Klinik für Thoraxchirurgie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland.
Zentralbl Chir. 2024 Aug;149(S 01):S35-S44. doi: 10.1055/a-2353-6336. Epub 2024 Aug 13.
Immunotherapy has drastically changed the treatment of lung cancer not only in systemic disease but also in the perioperative setting in locally advanced non-small cell lung cancer. In particular, the neoadjuvant and perioperative therapy regimes of the CheckMate 816 and KEYNOTE-671 studies as well as the adjuvant therapy according to the IMPower010 and the PEARLS/KEYNOTE-091 protocols have already been approved by the European Medicines Agency (EMA) for the treatment of selected cases. Other therapy protocols and combination therapies with varying drug classes and therapy modalities are currently being examined for their effectiveness and tolerance. The new treatment landscape creates new opportunities but also challenges for the treating disciplines. This article will focus on the current evidence for perioperative immunotherapy for resectable lung cancer and the resulting therapy standards, especially with regard to patient selection for both neoadjuvant and adjuvant immunotherapy, as well as current research efforts.
免疫疗法不仅在全身性疾病的治疗中,而且在局部晚期非小细胞肺癌的围手术期治疗中,都极大地改变了肺癌的治疗方式。特别是,CheckMate 816和KEYNOTE-671研究的新辅助和围手术期治疗方案,以及根据IMPower010和PEARLS/KEYNOTE-091方案进行的辅助治疗,已经获得欧洲药品管理局(EMA)批准用于特定病例的治疗。目前正在研究其他治疗方案以及不同药物类别和治疗方式的联合疗法的有效性和耐受性。新的治疗格局为治疗学科带来了新机遇,但也带来了挑战。本文将重点关注可切除肺癌围手术期免疫治疗的当前证据及由此产生的治疗标准,特别是关于新辅助和辅助免疫治疗的患者选择,以及当前的研究进展。