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免疫疗法在可切除非小细胞肺癌中的作用。

The role of immunotherapy in resectable non-small-cell lung cancer.

作者信息

Moloney Conor D, Forde Patrick M

机构信息

Beaumont RCSI Cancer Centre, Dublin, V09 V2N0, Ireland.

Trinity St. James's Cancer Institute, Trinity College Dublin, Dublin, D08 XF38, Ireland.

出版信息

Ther Adv Med Oncol. 2025 Aug 22;17:17588359251361883. doi: 10.1177/17588359251361883. eCollection 2025.


DOI:10.1177/17588359251361883
PMID:40861315
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12374111/
Abstract

Non-small-cell lung cancer (NSCLC) accounts for 80%-85% of all lung cancer cases, being the leading cause of cancer-related mortality worldwide. Historically, outcomes for patients with resectable disease have trailed those with other solid organ malignancies. Advances in treatment strategies, particularly in immunotherapy (IO), have revolutionised the landscape of lung cancer care. In resectable NSCLC (rNSCLC), including stage III disease, the integration of immunotherapy is increasingly being explored for its potential to reduce recurrences and improve survival outcomes. Several landmark clinical trials have resulted in regulatory approvals, and the rapid adoption of immunotherapy in the neoadjuvant, perioperative and adjuvant settings. This review will comprehensively examine the evolving role of immunotherapy in rNSCLC, with a focus on trial evidence, mechanisms of action, biomarkers and challenges in clinical implementation. We also discuss its implications for multimodal therapy across neoadjuvant, perioperative and adjuvant settings while highlighting potential future directions and identifying unanswered questions.

摘要

非小细胞肺癌(NSCLC)占所有肺癌病例的80%-85%,是全球癌症相关死亡的主要原因。从历史上看,可切除疾病患者的治疗结果落后于其他实体器官恶性肿瘤患者。治疗策略的进步,特别是免疫疗法(IO),彻底改变了肺癌护理的格局。在可切除的NSCLC(rNSCLC)中,包括III期疾病,免疫疗法的整合因其降低复发率和改善生存结果的潜力而越来越受到探索。几项具有里程碑意义的临床试验已获得监管批准,免疫疗法在新辅助、围手术期和辅助治疗中的应用迅速普及。本综述将全面探讨免疫疗法在rNSCLC中不断演变的作用,重点关注试验证据、作用机制、生物标志物以及临床实施中的挑战。我们还将讨论其在新辅助、围手术期和辅助治疗环境中对多模式治疗的影响,同时强调潜在的未来方向并确定未解决的问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b01b/12374111/69342c4c4c30/10.1177_17588359251361883-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b01b/12374111/69342c4c4c30/10.1177_17588359251361883-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b01b/12374111/69342c4c4c30/10.1177_17588359251361883-fig1.jpg

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本文引用的文献

[1]
Neoadjuvant Osimertinib for Resectable -Mutated Non-Small Cell Lung Cancer.

J Clin Oncol. 2025-6-2

[2]
Overall Survival with Neoadjuvant Nivolumab plus Chemotherapy in Lung Cancer.

N Engl J Med. 2025-6-2

[3]
Perioperative durvalumab plus chemotherapy plus new agents for resectable non-small-cell lung cancer: the platform phase 2 NeoCOAST-2 trial.

Nat Med. 2025-5-31

[4]
Ivonescimab versus pembrolizumab for PD-L1-positive non-small cell lung cancer (HARMONi-2): a randomised, double-blind, phase 3 study in China.

Lancet. 2025-3-8

[5]
Asian Thoracic Oncology Research Group expert consensus statement on the peri-operative management of non-small cell lung cancer.

Lung Cancer. 2025-2

[6]
Neoadjuvant Nivolumab Plus Ipilimumab Versus Chemotherapy in Resectable Lung Cancer.

J Clin Oncol. 2025-4-20

[7]
An international and multidisciplinary EORTC survey on resectability of stage III non-small cell lung cancer.

Lung Cancer. 2025-1

[8]
Perioperative tislelizumab plus neoadjuvant chemotherapy for patients with resectable non-small-cell lung cancer (RATIONALE-315): an interim analysis of a randomised clinical trial.

Lancet Respir Med. 2025-2

[9]
Divergent Clinical and Immunologic Outcomes Based on STK11 Co-mutation Status in Resectable KRAS-Mutant Lung Cancers Following Neoadjuvant Immune Checkpoint Blockade.

Clin Cancer Res. 2025-1-17

[10]
Impact of select actionable genomic alterations on efficacy of neoadjuvant immunotherapy in resectable non-small cell lung cancer.

J Immunother Cancer. 2024-10-23

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