Department of Oncology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Changling Road No.88, Xiqing District, Tianjin 300381, China; Tianjin Cancer Institute of Traditional Chinese Medicine, China; National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, China.
Department of Oncology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Changling Road No.88, Xiqing District, Tianjin 300381, China; Tianjin Cancer Institute of Traditional Chinese Medicine, China; National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, China.
Int Immunopharmacol. 2024 Nov 15;141:112903. doi: 10.1016/j.intimp.2024.112903. Epub 2024 Aug 14.
The reduction in lung cancer mortality rates over the past decade can be partially ascribed to advancements in immunotherapy. Immune checkpoint inhibitors (ICIs) have transformed the therapeutic landscape for advanced non-small cell lung cancer (NSCLC) and have recently been evaluated in multiple clinical trials to confirm their safety and efficacy in the neoadjuvant, adjuvant and perioperative settings for patients with resectable NSCLC. The Food and Drug Administration (FDA) has granted approval for adjuvant atezolizumab following platinum-doublet chemotherapy, neoadjuvant nivolumab and platinum-doublet chemotherapy, adjuvant pembrolizumab after platinum-doublet chemotherapy, and neoadjuvant/adjuvant pembrolizumab for resectable NSCLC, with potential forthcoming approvals for additional agents or indications. Novel data, approvals, and emerging research findings are dramatically shifting the accepted standards of care over just a few years. Despite these advances, the optimal application of these treatments is not entirely straightforward. This article summarizes the biological rationale for immunotherapy and the important clinical trials regarding perioperative ICIs. We also further outline the controversies and future directions to better guide the individualized treatment of NSCLC patients.
过去十年中,肺癌死亡率的降低可以部分归因于免疫疗法的进步。免疫检查点抑制剂(ICI)改变了晚期非小细胞肺癌(NSCLC)的治疗格局,最近在多项临床试验中进行了评估,以确认其在可切除 NSCLC 患者的新辅助、辅助和围手术期环境中的安全性和疗效。美国食品和药物管理局(FDA)已批准在铂类双药化疗后辅助使用阿替利珠单抗、新辅助纳武利尤单抗和铂类双药化疗、铂类双药化疗后辅助使用派姆单抗,以及新辅助/辅助使用派姆单抗治疗可切除 NSCLC,其他药物或适应证也可能即将获得批准。新的数据、批准和新的研究结果在短短几年内就显著改变了公认的治疗标准。尽管取得了这些进展,但这些治疗方法的最佳应用并非完全显而易见。本文总结了免疫疗法的生物学原理和关于围手术期 ICI 的重要临床试验。我们还进一步概述了争议和未来方向,以更好地指导 NSCLC 患者的个体化治疗。
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