[肺癌经手术治疗:历史发展,现有证据和未来前景]
1Department of Thoracic Surgery, National Cancer Center Hospital East, Kashiwa, Japan.
Kyobu geka. The Japanese journal of thoracic surgery
|December 9, 2025
概括
新的术后治疗方法,如免疫检查点抑制剂和向疗法,显著改善非小细胞肺癌 (NSCLC) 患者的治疗结果,提供更好的生存率和减少手术后复发.
科学领域:
- 在瘤学瘤学.
- 癌症研究 癌症研究
- 胸部外科手术 胸部外科手术
背景情况:
- 非小细胞肺癌 (NSCLC) 是一个重大的全球健康挑战,其特点是手术后的高死亡率和复发率.
- 传统的外科化疗对可切除的NSCLC提供了适度的生存益处.
- 新兴疗法,包括免疫检查点抑制剂 (ICI) 和氨酸激酶抑制剂 (TKI),正在彻底改变治疗模式.
研究的目的:
- 对可切除非小细胞肺癌的术后治疗策略的最新进展进行审查.
- 突出标志性临床试验对当前治疗标准的影响.
- 确定持续的挑战和未来的方向,以优化NSCLC患者的治疗结果.
主要方法:
- 标志性临床试验的综述 (CheckMate 816,KEYNOTE-671,ADAURA,ALINA) 评估NSCLC中的外科手术期间的ICI和TKI.
- 对生存数据,病理反应率和生物标志物影响的分析.
- 综合当前的证据和专家意见对治疗整合和未来的研究.
主要成果:
- 在外科手术期间的ICI显示,对II-III期NSCLC的病理反应和无病生存率有显著的改善.
- 向治疗 (EGFR的osimertinib,ALK的alectinib) 已经为特定的NSCLC分子亚型制定了新的标准.
- 具有里程碑意义的试验证实了新药在传统化疗中更高的疗效.
结论:
- 免疫检查点抑制剂现在是可切除II-III期NSCLC的术后护理的组成部分.
- 向疗法改变了EGFR和ALK阳性NSCLC的治疗方法.
- 未来的研究应该专注于个性化药物,ctDNA监测和新的治疗组合,以进一步提高可切除的NSCLC的存活率.
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