非小细胞肺癌中驱动基因状态与免疫治疗相关性的研究进展  

Advances of the Correlation between Driver Gene Status and Immunotherapy in Non-small Cell Lung Cancer

作　　者：陈捷 姜达[1] 黄芳[1] Jie CHEN;Da JIANG;Fang HUANG(The Forth Hospital of Hebei Medical University, Shijiazhuang 050011, China)

机构地区：[1]河北医科大学第四医院肿瘤内科,石家庄050011

出　　处：《中国肺癌杂志》2019年第4期233-238,共6页Chinese Journal of Lung Cancer

摘　　要：近几年,针对阻断程序性死亡蛋白1(programmed cell death 1, PD-1)及其配体1(PD-1 ligand, PD-L1的免疫检查点抑制剂在非小细胞肺癌(non-small cell lung cancer, NSCLC)治疗中取得了里程碑式的意义。然而目前的免疫治疗还不够精准,在未经选择人群中有效率偏低,只有15%-20%患者能从中获益,且有发生超进展(hyperprogression, HP)的几率。因此,如何选择优势人群至关重要。虽然很多研究强调了肿瘤细胞表面PD-L1表达水平及肿瘤突变负荷(tumor mutation burden, TMB)检测等指标指导免疫治疗的重要性,然而基于各种障碍,目前PD-L1表达水平及TMB尚不能作为决定性、排除性的预测标志物。随着研究深入,我们发现肺癌驱动基因突变与PD-1/PD-L1信号的异常激活之间有着密切的联系,基因突变与免疫治疗疗效的相关性尚有广阔研究价值。本文就基因突变预测免疫检查点抑制剂疗效及HP可能的研究进展作一综述。In recent years, the checkpoint inhibitors targeted programmed cell death 1(PD-1) and its ligand 1(PD-1 ligand, PD-L1) achieved landmark significance in treating a variety of cancers including non-small cell lung cancer(NSCLC).However, current immunotherapy is not precise enough, only 15%-20% of the unselected patients can benefit from the therapy,and there is a possibility of hyperprogression(HP). Therefore, how to select the dominant population is crucial. Although many studies have emphasized the importance of PD-L1 and tumor mutation burden(TMB) and other indicators to guide immunotherapy, current PD-L1 expression level and mutation load cannot be used as a decisive and excluded predictive marker based on various obstacles. With the deepening of research, we found that there is a close relationship between lung cancerdriver gene mutation and aberrant activation of PD-1/PD-L1 signal pathways, and the correlation between gene mutation and immunotherapy efficacy has broad research value. This article will revolve around the above issues.

关 键 词：肺肿瘤 免疫治疗 驱动基因 超进展 

分 类 号：R734.2[医药卫生—肿瘤]