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新辅助免疫化学疗法在可切除的NSCLC中,具有SMARCA4变异

Li-Shan Peng¹, Qian Cui², Chao Zhang¹

¹Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; Guangdong Provincial Key Lab of Translational Medicine in Lung Cancer, Guangzhou, China.

Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer

|October 29, 2025

概括

新辅助免疫化学疗法在SMARCA4改变的非小细胞肺癌 (NSCLC) 中表现有前途,特别是在状细胞癌中. 然而,其他亚型,特别是具有KRAS突变的亚型,呈现出独特的免疫感冒,高风险特征.

科学领域:

在瘤学瘤学.
基因组学就是基因组学.
免疫治疗是一种免疫疗法.

背景情况:

新辅助免疫化学疗法改善了非小细胞肺癌 (NSCLC) 的结果.
这种治疗在SMARCA4改变的NSCLC (预后不佳的小组) 的疗效尚不清楚.
在肺腺癌中,SMARCA4的改变与侵袭性疾病和较差的存活率有关.

研究的目的:

评估新辅助免疫化疗在SMARCA4变异NSCLC患者中的疗效.
研究SMARCA4改变NSCLC的临床特征和瘤免疫微环境.
在这个患者群体中确定与治疗反应和生存相关的因素.

主要方法:

对29名SMARCA4变异NSCLC患者进行了回顾性分析,这些患者接受了新辅助免疫化学疗法治疗.
下一代测序用于全面的基因组分析.
使用分子功能肖像分析瘤免疫微环境.
与癌症基因组图谱 (TCGA) 对肺腺癌的数据进行比较.

主要成果:

在整体队列中,目标响应率为70.4%,病理完整响应 (pCR) 率为51.7%.
与腺癌 (28.6%) 相比,状细胞癌 (83.3%) 的pCR率显著更高.
改变SMARCA4的肺腺癌显示出更糟糕的生存和免疫感冒特征,KRAS/KEAP1/STK11共同突变预测了早期复发.

结论:

改变SMARCA4的NSCLC是一种异质性疾病,对免疫化学疗法有不同的反应.
状细胞癌对新辅助免疫化学疗法具有很高的敏感性.
非状亚型,特别是具有KRAS和KEAP1/STK11共同突变的亚型,代表了一个免疫冷,高风险的亚组,需要不同的治疗策略.

关键词:

免疫治疗是一种免疫疗法.新辅助剂是一种新辅助剂.非小细胞肺癌是什么?这就是SMARCA4的标志.

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