免疫治疗在可切除的非小细胞肺癌中的新兴作用
Elizabeth G Dunne1, Cameron N Fick1, James M Isbell2
1Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
The Annals of thoracic surgery
|February 5, 2024
概括
在与化疗相结合时,外科免疫疗法显著改善了可切除非小细胞肺癌 (NSCLC) 患者的生存率. 这种方法是安全的,并提高了结果,尽管未来的试验将解决患者选择和最佳治疗持续时间.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 手术瘤学手术瘤学
背景情况:
- 可切除非小细胞肺癌 (NSCLC) 的长期存活率仍然很差,尽管进行了手术切除.
- 辅助化疗为局部晚期NSCLC提供了边际生存益处.
- 免疫检查点抑制剂 (ICI) 对晚期NSCLC具有前景,并且正在为切除性疾病在外科环境中进行评估.
研究的目的:
- 评估术后免疫治疗在可切除非小细胞肺癌 (NSCLC) 的疗效和安全性.
- 审查当前关于可切除NSCLC免疫治疗的临床试验数据.
- 确定未来研究NSCLC外科手术期免疫疗法的关键领域.
主要方法:
- 在PubMed的文献搜索中搜索了可切除NSCLC的免疫治疗临床试验.
- 包括关于生物标志物和免疫原始化策略的研究.
- 从随机的III期试验和报告结果的数据分析.
主要成果:
- 第三阶段试验表明,在NSCLC中,新辅助剂/辅助剂ICI (尼沃卢马布,布罗利祖马布,阿特佐利祖马布) 的无事件/无疾病生存率显著改善 (24%-42%).
- 在术后免疫疗法观察到的17% - 25%的病理完整反应率,超过单独的化疗.
- 术后ICI治疗显示出可比的发病率,并且与化疗相比,它不会对外科手术结果产生负面影响.
结论:
- 术后免疫疗法与化疗相结合,是一种安全有效的策略,可以改善可切除的NSCLC的结果.
- 需要进一步的研究,以优化患者选择术后免疫疗法.
- 化学免疫治疗后辅助ICI治疗的最佳持续时间和必要性需要进一步调查.
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