在高级NSCLC中优化免疫治疗持续时间的策略:当前的证据和未来的方向
Xue Dong1, Ruyue Li2, Xiujing Yao3
1Department of Respiratory Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, 250000, China; Department of Repiratory Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong, 250000, China.
在高级非小细胞肺癌中确定免疫检查点抑制剂的最佳持续时间至关重要. 生物标志物引导的策略可以个性化治疗,平衡疗效与降低毒性和成本.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 翻译医学是一种翻译医学.
背景情况:
- 免疫检查点抑制剂 (ICI) 已经改变了高级非小细胞肺癌 (NSCLC) 治疗.
- ICI治疗的最佳持续时间仍未确定,这可能会导致毒性和过度治疗的风险.
研究的目的:
- 审查证据,比较固定的持续时间与持续的ICI治疗在先进的NSCLC.
- 探索生物标志物在个性化ICI治疗持续时间中的作用.
- 提出一个框架,以优化ICI持续时间,平衡有效性和安全性.
主要方法:
- 对固定的持续时间与持续的ICI治疗现有证据的系统审查.
- 对生存,疾病控制和不良事件的影响分析.
- 评估生物标志物的实用性,包括循环瘤DNA (ctDNA) 动力学.
主要成果:
- 将固定和连续ICI持续时间进行比较的证据正在发展.
- 像ctDNA动力学这样的生物标志物在监测反应和指导治疗方面提供了精确性.
- 停止后的管理策略,包括重新挑战,是很重要的.
结论:
- 需要个性化,基于生物标志物的方法来优化ICI持续时间在先进的NSCLC.
- 要平衡治疗效益与累积毒性和经济负担至关重要.
- 一个以患者为中心的框架可以指导个性化免疫疗法持续时间决策.
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