华西医学

华西医学

非小细胞肺癌免疫治疗——风景靓丽,更需追求完美

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肿瘤免疫治疗是继手术、放化疗、靶向治疗后新兴的第四大肿瘤治疗手段,已在实体瘤治疗中使患者获益。医学界对如何利用免疫系统对抗肿瘤这一问题已历经 150 余年的探索。自 2011 年首个免疫检查点抑制剂 ipilimumab 问世以来,以免疫检查点抑制剂为代表的肿瘤免疫治疗开始迅猛发展。多种程序性死亡蛋白-1 及其配体抑制剂相继斩获晚期非小细胞肺癌的二线甚至一线治疗适应证。但现阶段免疫检查点抑制剂治疗获益有限,未来还需继续探索免疫治疗潜在的生物标志物、免疫耐药机制,优化免疫治疗方案。

As emerging means of cancer treatment, immunotherapy is the fourth major therapeutic strategy after surgery, chemoradiotherapy, and targeted therapy, which benefits patients a lot. It has been more than 100 years for the medical community exploring how to harness the immune system to fight cancer. Since the advent of ipilimumab in 2011, the first checkpoint inhibitor, cancer immunotherapy represented by checkpoint inhibitors has exploded. Several programmed death protein-1 and programmed cell death ligand-1 inhibitors have successively been approved to treat advanced non-small cell lung cancer in the second-line setting or even the first-line setting. But checkpoint inhibitors therapy has only achieved limited benefit at the present stage. Exploring potential predictive biomarkers and mechanisms of resistance are in need of further consideration to optimize immunotherapy.

关键词: 非小细胞肺癌; 免疫检查点; 生物标志物; 免疫耐药

Key words: Non-small cell lung cancer; Checkpoint inhibitor; Biomarker; Immune resistance

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