通讯作者: 郑歆, 673576002@qq.com

DOI：10.12201/bmr.202501.00025

Clinical research progress of PD-1/PD-L1 inhibitor induction therapy in unresectable stage III non-small-cell lung cancer

• 摘要：对于不可切除的Ⅲ期NSCLC, 根治性同步放化疗是长期以来的标准治疗模式，但是在实际临床实践中，我国行同步放化疗的患者不足30%，更多患者采用了序贯放化疗的方式，如何进一步优化这类患者的治疗疗效成为一直以来的研究热点。随着免疫检查点抑制剂的出现，放化疗后免疫维持治疗已经成为不可切除的Ⅲ期NSCLC的标准治疗模式，但仍有约1/4患者由于放化疗期间出现肿瘤进展或毒性反应而治疗失败，为提高此类患者疗效，免疫诱导治疗模式的研究应运而生。PD-1/PD-L1抑制剂我国最常用的免疫治疗药物，本文总结了PD-1/PD-L1抑制剂免疫单药诱导模式、免疫联合化疗诱导模式以及免疫+化疗+抗血管靶向治疗诱导模式的临床研究数据，初步显示了免疫诱导治疗在不可切除的局部晚期NSCLC患者中的可行性和安全性，但由于目前临床研究多为单臂或回顾性研究，仍需更多的Ⅲ期随机对照研究的数据进一步来支持。

  关键词： 非小细胞肺癌; 免疫检查点抑制剂; 诱导治疗; 放疗.

   

  Abstract: Non-small-cell lung cancer (NSCLC) is the most common malignant tumor, and its incidence and mortality rate rank first in China. For patients with unresectable locally advanced NSCLC, radical concurrent chemoradiotherapy(cCRT) has been the standard treatment for a long time. However, less than 30% of patients in China actually receive radical cCRT, and more patients adopt sequential CRT. Therefore, how to further optimize the mode of CRT has been a research hotspot. Based on the PACIFIC study and the GEMSTONE-301 study, giving immunotherapy as consolidation after CRT has become the standard treatment for patients with unresectable locally advanced NSCLC. However, about 1/4 of these patients still failed due to tumor progression or toxic reactions during CRT. In order to improve the efficacy of these patients, studies on immune-induction therapy has emerged. PD-1/PD-L1 inhibitors are the most commonly used immunotherapy in China. This paper summarized the latest clinical study on the immune-induction therapy model, such as immune-monotherapy(AFT-16 study), immunotherapy combined with chemotherapy (KEYNOTE-799 study, GASTO-1091 study), and immunotherapy combined with chemotherapy and anti-VEGFR-targeted therapy (GASTO-1086 study). These studies have preliminarily demonstrated the feasibility and safety of immune-induction therapy in patients with unresectable locally advanced NSCLC. However, since most of the current clinical studies are single-arm or retrospective studies, it still needs further support from more phase Ⅲ randomized controlled study data.

  Key words: Carcinoma, Non-Small-Cell Lung; Immune Checkpoint Inhibitors; Neoadjuvant Therapy; Radiotherapy.

  提交时间：2025-01-09

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2024-12-23	bmr.202501.00025V1	下载

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