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免疫药物在非小细胞肺癌中的有效性

英文原题:Effectiveness of immunological agents in non-small cell lung cancer.

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Effectiveness of immunological agents in non-small cell lung cancer.

PubMed 2022/10/26(内容时间) Cancer Rep (Hoboken) Q3 · IF 2.5(JCR 2025)

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研究思路按摘要原文分段

非小细胞肺癌(NSCLC)仍在全球范围内夺走数百万人的生命。尽管其不良预后在很大程度上归因于缺乏充分且精准的检测技术,但癌细胞对免疫系统的抑制进一步增加了在早期阶段识别异常NSCLC肿瘤的难度。因此,癌症免疫治疗——即激活免疫系统并帮助其对抗肿瘤——近来已成为最受追捧的技术,尤其是在NSCLC晚期阶段,此时手术或化疗可能给患者带来也可能不带来所期望的生存获益。

本综述聚焦于晚期NSCLC临床试验中的各种免疫治疗干预措施及其疗效。简要讨论了抗PD-1/PD-L1药物和抗CTLA-4抗体等单克隆抗体、癌症疫苗、溶瘤病毒及过继性T细胞疗法。此外,还探讨了性别、年龄和种族对免疫检查点抑制剂疗效的影响,并提出了免疫肿瘤学领域未来可能的研究方向。

免疫治疗可单独使用,或与其他免疫制剂联合使用,或与化疗联合使用。然而,这些策略的疗效在很大程度上取决于各种人口学变量,因为有些患者对免疫治疗反应极佳,而另一些患者则完全无获益或出现疾病进展。通过靶向癌症的一个“标志性特征”(免疫逃逸),免疫治疗已改变了NSCLC的管理,尽管仍有一些障碍阻碍其完全发挥疗效。

所有这些免疫策略应在当前协同治疗的背景下进行解读,即这些药物可根据患者和肿瘤特征与化疗、放疗和/或手术联合使用,以制定最佳个体化治疗并取得更优结果。为更好地实现这一目标,需要进一步研究免疫治疗的成本效益以及性别、种族和年龄差异。

展开英文摘要原文

This review focuses on the various immunotherapeutic interventions and their efficacy in advanced NSCLC clinical trials. Monoclonal antibodies like anti-PD-1/PD-L1 agents and anti-CTLA-4 antibodies, cancer vaccines, oncolytic viruses and adoptive T cell therapy have been discussed in brief. Furthermore, the effects of gender, age, and race on the efficacy of immune checkpoint inhibitors and suggest plausible future approaches in the realm of immuno-oncology.

Immunotherapy is used alone or in combination either with other immunological agents or with chemotherapy. However, the efficacy of these strategies depends extensively on various demographic variables, as some patients respond perfectly well to immunotherapy, while others do not benefit at all or experience disease progression. By targeting a "hallmark" of cancer (immune evasion), immunotherapy has transformed NSCLC management, though several barriers prevent its complete effectiveness.

All these immunological strategies should be interpreted in the current setting of synergistic treatment, in which these agents can be combined with chemotherapy, radiotherapy, and, or surgery following patient and tumor characteristics to proportionate the best-individualized treatment and achieve superior results. To better pursue this goal, further investigations on cost-effectiveness and sex-gender, race, and age differences in immunotherapy are needed.

论文信息

作者
Rekulapelli A、E Flausino L、Iyer G、Balkrishnan R
单位
Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, Virginia, USA.United States
文献类型
综述 · 非美国政府资助研究
期刊
Cancer reports (Hoboken, N.J.)2023 Jan
原文标识
PubMed 36289059 · DOI 10.1002/cnr2.1739