NSCLCにおけるマルチモダリティ・キュレーティブ・インテント・トリートメント:前例のない変化の時代 2017-2025
Matthew Evison1,2, Tanya Ahmed3, Meenali Chitnis4
1Lung Cancer and Thoracic Surgery Directorate, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK m.evison@nhs.net.
Thorax
|September 5, 2025
まとめ
新しい免疫療法と標的療法により,II-III段階の非小細胞肺がん (NSCLC) の治療が変化しました. これらの進歩は新しい医療基準を 提供していますが 患者にとって最適な治療法を 確立するためには システムレベルでの適応が必要です
科学分野:
- 医療腫瘍学
- 胸部 外科
- 放射線腫瘍学
背景:
- マルチモダリティ治療は,ステージII-IIIの非小細胞肺がん (NSCLC) の標準治療である.
- 最近の臨床試験では,全身治療の選択肢が2017年以降大幅に変化しました.
- 免疫療法と標的治療は,現在,治療目的のNSCLC治療法の不可欠な部分となっています.
研究 の 目的:
- 治療目的のステージII-IIIのNSCLCにおける新しい全身療法に関する証拠をレビューする.
- これらの新しい治療法の臨床的影響と実施の課題について議論する.
- 複雑な治療選択のための治療アルゴリズムを提案する.
主な方法:
- 最新の文献レビュー
- 重要な臨床試験の証拠をまとめました.
- 臨床的影響と実施の障壁の分析
主要な成果:
- 新しい治療基準には,維持免疫療法,補助的なチロシンキナーゼ阻害剤, neoadjuvant/手術後の化学免疫療法が含まれています.
- ネオアジュバントおよび手術後の化学免疫療法は,手術経路における全身療法の吸収を増加させる可能性があります.
- 課題には,経路の再設計,ステージの精度,バイオマーカーのテスト,そして多学科的な意思決定が含まれます.
結論:
- 免疫療法と標的治療薬は 治療目的のNSCLCの治療を根本的に変えました
- ネオアジュバント/外科手術後の化学免疫療法は,多くの患者にとって最適の手術方法として提案されています.
- システムレベルの適応は,ステージII-IIIのNSCLCにおいて,バイオマーカー主導の患者中心のケアを提供するために不可欠です.
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