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大细胞神经内分泌癌全身治疗的临床实践综述

英文原题:Clinical practice review of systemic treatment in large cell neuroendocrine carcinoma.

PubMed 2026/05/26(内容时间) Transl Lung Cancer Res Q2 · IF 3.4(JCR 2025)

研究概要

肺大细胞神经内分泌癌(LCNEC)仅占所有原发性肺癌的 3.1%,与其他原发性肺癌相比极为罕见。

中文摘要

肺大细胞神经内分泌癌(LCNEC)仅占所有原发性肺癌的3.1%,相较其他原发性肺癌十分罕见。对于I、II或III期肺LCNEC,手术是首选一线治疗。然而,由于复发率较高,单纯手术往往不足以彻底控制疾病。研究显示,辅助铂类化疗可改善LCNEC患者生存。对于不可切除或转移性疾病,通常首先采用化疗,常见方案为顺铂或卡铂联合依托泊苷或伊立替康。但缓解率和生存率偏低,仍有改善空间。本综述将讨论目前正在研究的其他治疗方法。免疫治疗常用于小细胞肺癌,但尚未正式确立为肺LCNEC的治疗方案。双特异性T细胞衔接器(BiTE)也在当前试验中作为潜在疗法探索,并显示出前景。CAR-T(CAR-T)细胞和溶瘤病毒等新疗法也正在研究中。这些研究至关重要,因为大细胞神经内分泌癌患者的5年生存率通常较低,仅为35.5%,5年无复发生存率更低,为27.4%。鉴于该病侵袭性强且预后差,进一步研究十分必要。本文旨在回顾并总结LCNEC全身治疗的现有文献。

展开英文摘要原文

Large cell neuroendocrine carcinomas (LCNECs) of the lung make up only 3.1% of all primary lung cancers, making them highly uncommon when compared to other primary lung cancers. For patients with stage I, II, or III LCNEC of the lung, surgery is the preferred first-line treatment. However, due to high recurrence rates, surgery alone is often insufficient to fully treat patients' disease. Adjuvant therapy utilizing platinum-based chemotherapy has been shown to improve survival in patients with LCNEC. For patients with unresectable or metastatic disease, chemotherapy is generally the first line of treatment, often a combination of either cisplatin or carboplatin with etoposide or irinotecan. However, the low response and survival rates leave room for advancement. There are several other treatments currently being investigated, which will be discussed in this review. Immunotherapy, which is often used to treat small-cell lung cancers, is yet to officially be defined as a treatment for LCNEC of the lung. Additionally, bispecific T-cell engagers (BiTEs) are also being explored in current trials as potential treatments and show promise as a potential treatment. Novel therapies such as chimeric antigen receptor T (CAR-T) cells and oncolytic viruses are being investigated. These studies are critical as patients with large cell neuroendocrine cancers tend to demonstrate poor 5-year survival rates at 35.5%, and even worse rates of 5-year recurrence-free survival at 27.4%. Given the aggressive nature and poor prognosis, further research into this disease is critical. We aim to review and summarize the current literature on systemic treatment in LCNEC.

论文信息

作者
Cass AS、Luckage IC、Linden AG、Ramirez RA
单位
Vanderbilt-Ingram Cancer Center, Nashville, TN, USA.United States
文献类型
综述
期刊
Translational lung cancer research2026 May 31
原文标识
PubMed 42291344 · DOI 10.21037/tlcr-2025-1-1394