辐射疗法与免疫疗法的协同作用的挑战,以解锁转移性NSCLC中的abscopal效应:系统性审查
Jason Liu1, Howard West2, Heather M McGee3
1Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA 91010, United States.
概括
将放射治疗与免疫疗法结合起来,通过增强腹腔反应来治疗转移性非小细胞肺癌 (NSCLC) 是有前途的. 需要进一步的研究来优化治疗和尽量减少毒性.
科学领域:
- 在瘤学瘤学.
- 辐射瘤学 辐射瘤学
- 免疫治疗是一种免疫疗法.
背景情况:
- 免疫疗法最近取得了成功,人们对将其与放射治疗结合起来越来越感兴趣.
- 辐射和免疫疗法的协同作用对治疗转移性非小细胞肺癌 (NSCLC) 提出了挑战.
研究的目的:
- 审查目前关于结合放射疗法和免疫疗法治疗NSCLC的临床证据.
- 为了确定影响腹腔镜反应率的因素,并优化组合疗法策略.
主要方法:
- 对2000-2022年间发表的临床论文进行系统审查.
- 在MEDLINE/PubMed和Clinicaltrials.gov上进行的搜索使用了以下术语:"abscopal"",辐射或放射治疗"",NSCLC"和"肺".
主要成果:
- 早期研究表明,与传统疗法相比,低分离,较小场射线疗法可能会增强腹膜效应.
- 基于较高绝对淋巴细胞计数 (ALC),较低中性粒细胞与淋巴细胞比率 (NLR),PD-L1表达,不匹配修复缺陷和高瘤突变负担的患者选择可能会改善反应.
- 辐射输送的最佳时间和解剖位置仍未确定.
结论:
- 结合辐射和免疫疗法有望改善NSCLC的腹腔反应.
- 进一步的研究对于确定最佳治疗参数,患者选择标准和组合疗法的毒性管理至关重要.
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