非小细胞肺癌免疫检查点抑制剂再挑战治疗的临床研究现状  

The current status of clinical research on immune checkpoint inhibitors rechallenge in non-small cell lung cancer

作　　者：张辰阳 徐美玲[1,2,3] 陈荣铮 邢鹏飞[1,2,3] 孔月虹 赵向荣 张军军[1,2,3] 张力元[1,2,3] ZHANG Chenyang;XU Meiling;CHEN Rongzheng;XING Pengfei;KONG Yuehong;ZHAO Xiangrong;ZHANG Junjun;ZHANG Liyuan(Prague Treatment Center,The Second Affiliated Hospital of Soochow University,Suzhou 215104,Jiangsu Province,China;Tumor Diagnosis and Treatment Center,The Second Affiliated Hospital of Soochow University,Suzhou 215104,Jiangsu Province,China;Laboratory of Tumor radioimmunotherapy,The Second Affiliated Hospital of Soochow University,Suzhou 215104,Jiangsu Province,China)

机构地区：[1]苏州大学附属第二医院布拉格治疗中心,江苏苏州215104 [2]苏州大学附属第二医院肿瘤诊疗中心,江苏苏州215104 [3]苏州大学附属第二医院肿瘤放射免疫治疗实验室,江苏苏州215104

出　　处：《肿瘤》2024年第4期404-411,共8页Tumor

基　　金：国家自然科学基金(82171828);省部共建放射医学与辐射防护国家重点实验室内部协作课题(GZN1202302);江苏省科技项目(BE2021652);苏州市“科教兴卫”青年科技项目(KJXW2021018);北京白求恩公益基金会项目(STLKY0016);希思科-皮尔法伯肿瘤研究重点基金项目(Y-pierrefabre202102-0113);苏州市科技发展计划项目(SKY2022163);苏州市临床医学中心(Szlcyxzx202103);苏大附二院学科建设托举工程(XKTJHRC20210011);中国宝原投资有限公司科研项目(270004);苏州市姑苏人才卫生计划(GSWS2022028)

摘　　要：免疫检查点抑制剂的应用已改变晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的治疗模式。然而,因不可耐受的不良反应或因疾病进展而中断免疫检查点抑制剂治疗成为晚期NSCLC治疗的棘手问题。中断免疫检查点抑制剂治疗后,是否可行免疫检查点抑制剂再挑战治疗被提出且仍存在争议,对此本文总结了晚期NSCLC免疫检查点抑制剂再挑战的类型及治疗策略,并发现因免疫相关不良事件和临床决策而中断免疫治疗的NSCLC患者在重启免疫检查点抑制剂治疗后,仍能获得较好的临床效果。由此推测,耐药后的免疫检查点抑制剂再挑战治疗NSCLC是一种可供选择的挽救治疗手段。The application of immune checkpoint inhibitors has changed the treatment paradigm for advanced non-small cell lung cancer(NSCLC).However,interruption of immune checkpoint inhibitor therapy due to intolerable adverse effects or due to disease progression has become a problematic issue in the treatment of advanced NSCLC.Whether immune checkpoint inhibitors rechallenge therapy is possible after interruption of immune checkpoint inhibitor therapy has been proposed and remains controversial.This article summarizes the types of immune checkpoint inhibitor rechallenge and therapeutic strategies for advanced NSCLC,and finds that patients with NSCLC who have interrupted their immunotherapy due to immune-related adverse events and clinical decision-making can still achieve a better favorable clinical outcomes.It is hypothesized that immune checkpoint inhibitor rechallenge for NSCLC after drug resistance is an alternative salvage therapy.

关 键 词：非小细胞肺癌 免疫检查点抑制剂 再挑战 

分 类 号：R734.2[医药卫生—肿瘤]