小细胞肺癌免疫治疗专家共识(2025版)  

Expert consensus on immunotherapy for small cell lung cancer(2025 edition)

作　　者：中国临床肿瘤学会小细胞肺癌专家委员会 中国医师协会肿瘤多学科诊疗专业委员会 程颖[2] 王洁 张爽[4] 柳菁菁[4] 张良[4] 段建春[5] Experts Committee on Small-Cell Lung Cancer of Committee of the Chinese Society of Clinical Oncology;Multidisciplinary Cancer Diagnosis and Treatment Committee of Chinese Medical Doctor Association;Cheng Ying;Wang Jie(不详;Department of Thoracic Oncology,Jilin Cancer Hospital,Changchun 130000,China;Department of Medical Oncology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]不详 [2]吉林省肿瘤医院胸部肿瘤内科,长春130000 [3]国家癌症中心国家肿瘤临床医学研究中心,中国医学科学院北京协和医学院肿瘤医院内科,北京100021 [4]吉林省肿瘤医院胸部肿瘤内科 [5]中国医学科学院肿瘤医院山西医院内科

出　　处：《中华肿瘤杂志》2025年第1期65-75,共11页Chinese Journal of Oncology

摘　　要：肺癌是全球发病率和死亡率较高的恶性肿瘤之一,小细胞肺癌是一种具有高度侵袭性的神经内分泌肿瘤,与严重的烟草暴露密切相关,占所有肺癌类型的13%~15%。小细胞肺癌具有生长迅速、易早期转移等特征,诊断时大约70%已经出现转移,为广泛期小细胞肺癌。1980—2018年,化疗和放疗是小细胞肺癌主要的治疗策略。依托泊苷联合铂类化疗一直是小细胞肺癌一线标准治疗方案。尽管小细胞肺癌对初始治疗非常敏感,但绝大多数患者在6个月内出现疾病进展,而且复发后的治疗选择非常有限,中位生存时间也只有8~10个月左右。随着免疫检查点抑制剂尤其是程序性死亡受体配体1和程序性死亡受体1抑制剂的出现,为小细胞肺癌患者带来了新的希望,免疫检查点抑制剂联合化疗使广泛期小细胞肺癌患者的生存获得显著延长,成为广泛期小细胞肺癌一线治疗新的标准。目前,已有越来越多的免疫检查点抑制剂在国内获批用于治疗小细胞肺癌,这为小细胞肺癌患者提供了更多的治疗选择。为进一步规范小细胞肺癌免疫治疗临床实践,基于国内外指南、共识和相关循证医学证据,中国临床肿瘤学会小细胞肺癌专家委员会和中国医师协会肿瘤多学科诊疗专业委员会组织专家制定了《小细胞肺癌免疫治疗专家共识(2025版)》,以期为中国临床医师提供参考和指导。Lung cancer is one of the malignant tumors with high morbidity and mortality worldwide.Small cell lung cancer(SCLC)is a highly aggressive neuroendocrine tumor that is closely associated with tobacco exposure,accounting for 13%to 15%of all lung cancer cases.It is characterized by a high proliferation rate and exceptional metastatic capacity.At the time of diagnosis,approximately 70%of the patients have metastasized and are classified as extensive-stage small cell lung cancer(ES-SCLC).From 1980 to 2018,chemotherapy and radiotherapy were the main treatment strategies for SCLC.Etoposide combined with platinum has remained the standard first-line treatment for ES-SCLC.Although SCLC is very sensitive to initial treatment,the majority of patients have disease progression within 6 months,and treatment options after recurrence are very limited,and the median survival time is only about 8-10 months.The advent of immune checkpoint inhibitors(ICIs),particularly programmed death-ligand 1(PD-L1)and programmed death-1(PD-1)inhibitors,has brought new hope to patients with SCLC.PD-1/PD-L1 plus chemotherapy have significantly prolonged overall survival of patients with ES-SCLC,which has become the new standard of first-line treatment for ES-SCLC.Currently,a raised number of immune checkpoint inhibitors(ICIs)have been approved in China for the treatment of SCLC,providing more treatment options for SCLC patients.To further standardize the clinical practice of SCLC immunotherapy,the"Expert consensus on immunotherapy for SCLC(2025 edition)"has been developed based on domestic and international guidelines,consensus,and relevant medical evidence,aiming to provide reference and guidance for domestic clinicians.

关 键 词：肺肿瘤 小细胞肺癌 免疫治疗 免疫检查点抑制剂 专家共识 

分 类 号：R734.2[医药卫生—肿瘤]