Rahnea-Nita Gabriela, Corobcean Nadejda, Constantin Georgiana Bianca, Nechifor Alexandru, Maier Adrian-Cornel, Rahnea-Nita Roxana-Andreea, Firescu Dorel, Rebegea Laura-Florentina
Specific Disciplines Department, Faculty of Nursery and Midwifery, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
M Hospital, 077190 Voluntari, Romania.
J Clin Med. 2025 May 13;14(10):3394. doi: 10.3390/jcm14103394.
: Advances in the treatment of non-small cell lung cancer in the last 5 years (new techniques in radiotherapy, including stereotactic ablative radiotherapy, new targeted therapies and advances in immunotherapy) have increased the survival rates of patients diagnosed with this disease. : Our study refers to a patient diagnosed in July 2017 with stage IV A lung cancer, cT3 N3 M1b (poorly differentiated adenocarcinoma, EGFR, ALK and PDL 1 negative), who underwent five lines of treatment and who has, at the time of writing this article (March 2025), a very good performance status, currently undergoing maintenance chemotherapy. : The results obtained confirm the revolutionary role of immunotherapy, but also the importance of chemotherapy and external radiotherapy, suggesting the synergistic effect between these three therapies. We also performed a literature review, highlighting the resistance to immunotherapy, rechallenge with immunotherapy, progression of metastatic NSCLC after first-line chemo-immunotherapy and the role of chemotherapy in line II and III after progression of NSCLC to immunotherapy. : Results of studies evaluating new agents and their combinations, along with analysis of the mechanisms of evolution of primary and acquired resistance to immunotherapy are awaited, with the aim of selective and personalized treatment options to improve the survival and the quality of life for this category of patients.
在过去5年中，非小细胞肺癌的治疗取得了进展（放射治疗新技术，包括立体定向消融放疗、新的靶向治疗以及免疫治疗的进展），提高了被诊断患有这种疾病的患者的生存率。我们的研究涉及一名于2017年7月被诊断为IV A期肺癌的患者，cT3 N3 M1b（低分化腺癌，EGFR、ALK和PDL 1阴性），该患者接受了五线治疗，在撰写本文时（2025年3月），其身体状况良好，目前正在接受维持化疗。所获得的结果证实了免疫治疗的革命性作用，也证实了化疗和外照射放疗的重要性，表明这三种治疗之间具有协同作用。我们还进行了文献综述，强调了对免疫治疗的耐药性、免疫治疗的再次挑战、一线化疗免疫治疗后转移性非小细胞肺癌的进展以及非小细胞肺癌进展为免疫治疗后二线和三线化疗的作用。评估新药物及其组合的研究结果，以及对免疫治疗原发性和获得性耐药演变机制的分析，有待进一步观察，目的是提供选择性和个性化的治疗方案，以提高这类患者的生存率和生活质量。
