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重塑II期和III期非小细胞肺癌治疗方案:为前沿免疫肿瘤学疗法做好医疗准备。

Revamping Non-Small Cell Lung Cancer Treatments in Stages II and III: Preparing Healthcare for Cutting-Edge Immuno-Oncology Regimens.

作者信息

Bertolaccini Luca, Casiraghi Monica, Bardoni Claudia, Diotti Cristina, Chiari Matteo, Mazzella Antonio, de Marinis Filippo, Spaggiari Lorenzo

机构信息

Department of Thoracic Surgery, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141 Milan, Italy.

Department of Thoracic Oncology, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy.

出版信息

Cancers (Basel). 2024 Aug 14;16(16):2842. doi: 10.3390/cancers16162842.

Abstract

Non-small cell lung cancer (NSCLC) poses a significant challenge in clinical oncology, necessitating continual refinement of treatment approaches in stages II and III. Recent advancements have highlighted the potential of neoadjuvant therapy in optimising patient outcomes. Biomarker testing guides neoadjuvant therapy decisions, including epidermal growth factor receptor (EGFR) mutation and programmed death-ligand 1 (PD-L1) expression testing. Neoadjuvant therapy aims to improve oncological outcomes by treating micrometastatic disease and assessing tumour response before surgery. Disease-free survival is a surrogate endpoint for overall survival in both neoadjuvant and adjuvant settings. Multidisciplinary collaboration is crucial for individualised treatment planning and optimising patient care. The management of NSCLC requires a comprehensive approach, integrating expertise across disciplines and tailoring treatment strategies to individual patient needs. Neoadjuvant therapy shows promise in improving long-term outcomes, with biomarker testing guiding treatment decisions. Challenges such as defining borderline resectability and differentiating pseudoprogression highlight the need for ongoing research and collaboration.

摘要

非小细胞肺癌(NSCLC)在临床肿瘤学中构成了重大挑战,这使得II期和III期的治疗方法需要不断完善。最近的进展凸显了新辅助治疗在优化患者预后方面的潜力。生物标志物检测指导新辅助治疗决策,包括表皮生长因子受体(EGFR)突变检测和程序性死亡配体1(PD-L1)表达检测。新辅助治疗旨在通过治疗微转移疾病并在手术前评估肿瘤反应来改善肿瘤学预后。无病生存期是新辅助和辅助治疗中总生存期的替代终点。多学科协作对于个体化治疗规划和优化患者护理至关重要。NSCLC的管理需要一种综合方法,整合各学科的专业知识并根据个体患者需求定制治疗策略。新辅助治疗在改善长期预后方面显示出前景,生物标志物检测指导治疗决策。诸如定义临界可切除性和区分假性进展等挑战凸显了持续研究与协作的必要性。

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