晚期肺癌PD1/PD-L1单抗免疫治疗现状与思考  

Current status and thoughts on immunotherapy with PD1/PD-L1 monoclonal antibodies for advanced lung cancer

作　　者：钱哲[1] 胡瑛[1] 林根 QIAN Zhe;HU Ying;LIN Gen(Cancer Center,Beijing Chest Hospital,Capital Medical University,Beijing 101149,China)

机构地区：[1]首都医科大学附属北京胸科医院肿瘤中心,北京101149

出　　处：《中国临床新医学》2024年第12期1325-1330,共6页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：肺癌是全球发病率和死亡率最高的恶性肿瘤,近年来以程序性细胞死亡受体1(PD1)/程序性死亡受体配体1(PD-L1)单抗为代表的免疫检查点抑制剂在肺癌治疗中取得了显著进展。在晚期非小细胞肺癌中,PD1/PD-L1单抗免疫治疗已成为一线标准治疗方案,特别是在PD-L1高表达的患者中,单药免疫治疗相较于传统化疗可显著提高疗效并减少不良反应。此外,免疫治疗与其他治疗的联合应用,如免疫+化疗、双免方案等,也在非小细胞肺癌的治疗中得到了广泛认可。对于晚期小细胞肺癌,PD1/PD-L1单抗免疫治疗也打破了传统一线治疗的瓶颈,显著改善了患者的预后。然而,免疫治疗仍存在诸多挑战,如敏感患者筛选、克服耐药、联合治疗的选择以及不良反应的处理等。未来,双抗类药物、新型免疫治疗药物研发将成为打破肺癌免疫治疗瓶颈的关键。同时,免疫治疗在联合治疗、耐药防治等方面的研究也将不断深入,为肺癌患者带来更长久的生存获益。Lung cancer is a malignant tumor with the highest incidence and mortality rates worldwide.In recent years,immune checkpoint inhibitors represented by programmed cell death protein 1(PD1)/programmed death-ligand 1(PD-L1)monoclonal antibodies have made significant progress in the treatment of lung cancer.In advanced non-small-cell lung cancer,the immunotherapy with PD1/PD-L1 monoclonal antibodies has become a first-line standard treatment option,especially for the patients with high PD-L1 expression,in whom single-agent immunotherapy can significantly improve the efficacy and reduce adverse reactions compared with traditional chemotherapy.In addition,the combination of immunotherapy and other treatments,such as immunotherapy+chemotherapy and two immunotherapy regimens,has also been widely accepted in the treatment of non-small-cell lung cancer.For advanced small-cell lung cancer,the immunotherapy with PD1/PD-L1 monoclonal antibodies has also broken through the bottleneck of traditional first-line treatment and has significantly improved the prognosis of the patients.However,there are still many challenges in immunotherapy,such as the selection of sensitive patients,overcoming drug resistance,the choice of combination therapy,and the management of adverse reactions.In the future,the development of dual-antibody drugs and new types of immunotherapy drugs will become the key to breaking through the bottleneck of immunotherapy for lung cancer.At the same time,researches on immunotherapy in the combination therapy and the prevention and treatment of drug resistance will continue to deepen,bringing more long-term survival benefits to lung cancer patients.

关 键 词：肺癌 程序性细胞死亡受体1/程序性死亡受体配体1 免疫治疗 

分 类 号：R734.2[医药卫生—肿瘤]