免疫再挑战在非小细胞肺癌治疗中的研究  

Research on Immune Rechallenge in the Treatment of Non-Small Cell Lung Cancer

作　　者：皇甫睿 苗春蕾 侯坤 朱贲贲 平耀东[2,3] 武世奎 HUANG Furui;MIAO Chunlei;HOU Kun;ZHU Benben;PING Yaodong;WU Shikui(School of Pharmacy,Inner Mongolia Medical University,Hohhot 010110,China;Department of Pharmacy,Peking University Cancer Hospital Inner Mongolia Hospital,Hohhot 010050,China;MOE Key Laboratory of Carcinogenesis and Translational Research,Department of Pharmacy,Peking University Cancer Hospital&Institute,Beijing 100142,China)

机构地区：[1]内蒙古医科大学药学院,呼和浩特010110 [2]北京大学肿瘤医院内蒙古医院药剂科,呼和浩特010050 [3]北京大学肿瘤医院暨北京市肿瘤防治研究所药剂科,恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《中国药学杂志》2024年第23期2293-2298,共6页Chinese Pharmaceutical Journal

基　　金：中关村精准医学基金会医健公益行—药学科研专项资助(ZGC-YXKY-49)。

摘　　要：目的总结免疫再挑战在非小细胞肺癌(non-small cell lung cancer,NSCLC)治疗方面的研究进展及获益人群,为临床实践中NSCLC的治疗提供参考。方法以“非小细胞肺癌”“免疫检查点抑制剂”“再挑战”等为关键词,采用主题词和自由词相结合的方法,检索了PubMed、Cochrane Library、embase、中国知网等数据库自建库起至2024年2月1日的相关文献。结果共检索到相关文献526篇,有效文献40余篇。其中关于NSCLC再挑战的系统性评价/Meta分析6篇,临床研究5篇,其余大多数为回顾性真实世界研究。结论分析了NSCLC免疫再挑战治疗的有效性及可控的免疫相关不良反应(immune-related adverse events,irAEs),并初步认为程序性细胞死亡蛋白配体1(programmed cell death ligand 1,PD-L1)高表达(TPS≥50%)、美国东部协作肿瘤组(Eastern Cooperative Oncology Group,ECOG)体能状况(performance status,PS)评分较好(PS≤1分)及初始免疫治疗时间较长的患者更有可能从免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)再挑战中获益。OBJECTIVE To summarize the research progress and beneficiary population of immune re challenge in the treatment of non-small cell lung cancer(NSCLC),and provide reference for the treatment of NSCLC in clinical practice.METHODS Using keywords such as“non-small cell lung cancer”,“immune checkpoint inhibitor”,“rechallenge”,etc.,a combination of topic words and free words was used to search relevant literature from PubMed、Cochrane Library、embase、self-built databases such as China National Knowledge Infrastructure until February 1,2024.RESULTS A total of 526 relevant literature were retrieved,with over 40 valid articles.Among them,there are 6 systematic reviews/Meta analyses on NSCLC rechallenge,5 clinical studies,and most of the rest are retrospective real-world studies.CONCLUSION The effectiveness and controllable irAEs of immune rechallenge therapy for NSCLC were analyzed,and it was preliminarily believed that patients with high programmed cell death ligand 1(PD-L1)expression(TPS≥50%),good performance status(PS)score in the Eastern Cooperative Oncology Group(ECOG)in the United States(ECOG-PS≤1)and longer initial immunotherapy time were more likely to benefit from ICIs rechallenge.

关 键 词：非小细胞肺癌 免疫治疗 再挑战 疗效 安全性 

分 类 号：R966[医药卫生—药理学]