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可切除非小细胞肺癌免疫治疗现状

英文原题:Current Status of Immunotherapy in Resectable Lung Cancer.

PubMed 2025/11/04(内容时间) Indian J Surg Oncol Q4 · IF 0.7(JCR 2025)

研究概要

肺癌是全球癌症相关死亡的首要原因,印度在该疾病负担中占相当大的比例。

中文摘要

肺癌是全球癌症相关死亡的首要原因,其中印度占该疾病负担的相当大份额。尽管外科技术和辅助治疗取得了进展,但非小细胞肺癌(NSCLC)和小细胞肺癌(SCLC)的预后仍然不理想,尤其是在晚期阶段。免疫治疗的引入显著改变了治疗格局。虽然最初用于转移性和不可切除性疾病,但免疫治疗现已在可切除NSCLC的围手术期管理中逐渐获得应用。IMpower010、CheckMate 816和KEYNOTE-091等关键试验已证明预后有意义的改善,促使治疗方案发生转变。这一演变要求通过将免疫反应评估纳入手术规划、免疫相关毒性的管理以及多学科协调来拓宽治疗范围。此外,包括癌症疫苗、TIL(肿瘤浸润淋巴细胞)疗法和个性化免疫治疗策略在内的新兴模式正在推动传统外科范式的边界。本综述批判性地审视了当前支持免疫治疗用于肺癌的证据,特别强调其对外科的影响。将免疫治疗整合到外科肿瘤学中代表着一项重大进步,为改善预后提供了机会,同时在患者选择、时机和多学科管理方面带来了新的挑战。随着印度面临肺癌发病率不断上升,免疫治疗联合手术的作用在未来具有前景,将改变患者护理。

展开英文摘要原文

Lung cancer is the foremost cause of cancer-related mortality globally, with India accounting for a considerable share of the disease burden. Despite progress in surgical techniques and adjuvant therapies, outcomes for both non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) remain suboptimal, particularly in advanced stages. The introduction of immunotherapy has significantly altered the therapeutic landscape. While initially employed in metastatic and unresectable disease, immunotherapy is now gaining traction in the perioperative management of resectable NSCLC. Pivotal trials such as IMpower010, CheckMate 816, and KEYNOTE-091 have demonstrated meaningful improvements in outcomes, prompting a shift in treatment protocols. This evolution necessitates a broader scope of treatment through incorporation immunologic response assessment into operative planning, management of immune-related toxicities, and multidisciplinary coordination. Furthermore, emerging modalities including cancer vaccines, tumour-infiltrating lymphocyte therapy, and personalised immunotherapy strategies are pushing the boundaries of conventional surgical paradigms. This review critically examines current evidence supporting immunotherapy in lung cancer with particular emphasis on surgical implications. The integration of immunotherapy into surgical oncology represents a significant advancement, offering opportunities for improved outcomes while presenting new challenges in patient selection, timing, and multidisciplinary management. As India confronts a rising incidence of lung cancer, the role of immunotherapy with surgery holds promise for the future, transforming patient care.

论文信息

作者
Deshmukh P、Abughanimeh O、Ganti AK
第一作者单位
Department of Medicine, Smt. Kashibai Navale Medical College and General Hospital, Pune, Maharashtra India.India
通讯作者单位
Division of Oncology-Hematology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198-6840 USA.United States
文献类型
综述
期刊
Indian journal of surgical oncology2025 Jul
原文标识
PubMed 42558669 · DOI 10.1007/s13193-025-02470-x