Shen Yili, Liu Zhicong, Chen Yi, Shi Xuefei, Dong Shunli, Wang Bin
Department of Respiratory Medicine, Huzhou Central Hospital, Affiliated Central Hospital, Huzhou University, Huzhou, Zhejiang, China.
Huzhou Key Laboratory of Precision Diagnosis and Treatment in Respiratory Diseases, Huzhou Central Hospital, Huzhou, Zhejiang, China.
Curr Treat Options Oncol. 2025 Feb;26(2):73-83. doi: 10.1007/s11864-025-01292-x. Epub 2025 Jan 22.
Small-cell lung cancer accounts for about 15% of lung cancers with an extremely poor prognosis. The incorporation of immunotherapy to platinum-based chemotherapy offers sustained overall survival benefits and become the standard for the first-line setting of extensive-stage small-cell lung cancer. However, only a limited number of patients derive prolonged benefits. Although novel immunomodulatory agents and combination strategies are currently under investigation, identifying patients who are likely to obtain clinical benefits from this therapeutic approach is urgently needed. The modest therapeutic response to immunotherapy can be explained by various mechanisms. Traditional biomarkers do not guide immunotherapeutic decision-making in small-cell lung cancer. Notably, recent progress in the understanding of the molecular typing of small-cell lung cancer based on multi-omics data might bring new sights. This review summarizes the potential biomarkers for small-cell lung cancer immunotherapy based on clinical trials and preclinical studies. Moreover, important constraints in identifying biomarkers for small-cell lung cancer treatment are discussed.
小细胞肺癌约占肺癌的15%，预后极差。免疫疗法联合铂类化疗可带来持续的总生存获益，并成为广泛期小细胞肺癌一线治疗的标准。然而，只有少数患者能获得长期获益。尽管目前正在研究新型免疫调节剂和联合治疗策略，但迫切需要确定哪些患者可能从这种治疗方法中获得临床益处。免疫疗法治疗反应有限可由多种机制解释。传统生物标志物无法指导小细胞肺癌的免疫治疗决策。值得注意的是，基于多组学数据对小细胞肺癌分子分型的最新认识进展可能带来新的见解。本综述基于临床试验和临床前研究总结了小细胞肺癌免疫治疗的潜在生物标志物。此外，还讨论了小细胞肺癌治疗生物标志物识别中的重要限制因素。
