小细胞肺癌免疫治疗耐药机制及后线治疗策略研究进展  

Research progress of immunotherapy resistance mechanism and posterior treatment strategy of small cell lung cancer

作　　者：李美 翟旭杰[2] 范勃 白元松[1] LI Mei;ZHAI Xujie;FAN Bo;BAI Yuansong(Department of Oncology and Hematology;Department of Breast Surgery,China-Japan Union Hospital of Jilin University,Changchun 130033,China)

机构地区：[1]吉林大学中日联谊医院肿瘤血液科,吉林长春130033 [2]吉林大学中日联谊医院乳腺外科,吉林长春130033

出　　处：《中国实验诊断学》2025年第1期117-120,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：免疫治疗是小细胞肺癌(small cell lung cancer,SCLC)的重要治疗手段之一,极大改善患者的预后。但由于治疗期间出现迅速耐药,导致很大一部分患者无法从中受益。本文总结了针对SCLC免疫治疗中产生耐药性的关键分子机制的最新研究,包括PD-L1表达缺失、抗原呈递受损、T细胞本身缺乏和浸润受限、PI3K/AKT信号通路的激活、基因组损伤和克隆多样性爆发等。我们还探索了对免疫治疗耐药后进展的策略,包括免疫治疗再挑战的可能、联合放疗、联合抗血管生成药物及其他可能疗法,为提高SCLC免疫治疗的临床疗效提供参考。Immunotherapy is one of the important treatments for small cell lung cancer(SCLC),which greatly improves the prognosis of patients.However,due to rapid drug resistance during treatment,a large proportion of patients cannot benefit from it.This article summarizes the latest research on the key molecular mechanisms of drug resistance in SCLC immunotherapy,including the loss of PD-L1expression,impaired antigen presentation,lack of T cells and limited infiltration,activation of PI3K/AKT signaling pathway,genomic damage and clonal diversity outbreaks.We also explored strategies for progression after resistance to immunotherapy,including the possibility of re-challenge of immunotherapy,combined radiotherapy,combined anti-angiogenic drugs,and other possible therapies,to provide a reference for improving the clinical efficacy of immunotherapy for SCLC.

关 键 词：小细胞肺癌 免疫耐药 后线治疗 

分 类 号：R734.2[医药卫生—肿瘤]