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| 晚期非小细胞肺癌一线免疫治疗耐药机制及其对策的研究进展 |
| Research Progress on Drug Resistance Mechanisms and Countermeasures of First-line Immunotherapy for Advanced non-small Cell Lung Cancer |
| 投稿时间：2025-08-06 修订日期：2025-11-17 |
| DOI： |
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| 中文关键词: 非小细胞肺癌 免疫治疗耐药 二线治疗 |
| 英文关键词:Non-small cell lung cancer Immunotherapy Drug resistance Second-line therapy |
| 基金项目:吴阶平医学基金会 |
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| 中文摘要: |
| 免疫治疗是晚期非小细胞肺癌（Non-Small Cell Lung Cancer，NSCLC)一线治疗的重要手段。而大多数患者都会面临耐药，耐药并非单一事件，而是肿瘤在免疫压力下动态演化的结果。其核心机制涵盖肿瘤细胞的免疫原性下调和肿瘤微环境的免疫抑制性重塑。针对一线免疫耐药后的二线治疗方案存在争议，目前临床上主要考虑患者的具体病情、体力状况、PD-L1表达情况、驱动基因突变状态以及前期治疗反应等因素来制定个性化治疗策略。二线化疗,靶向,免疫再挑战都是可选的策略,也有双免、ADC等新药的陆续出现。本综述主要介绍晚期NSCLC一线免疫耐药后二线不同的治疗方案。 |
| 英文摘要: |
| Immunotherapy is an important means of first-line treatment for advanced Non-Small Cell Lung Cancer (NSCLC). Most patients will encounter drug resistance. Drug resistance is not a single event but the result of the dynamic evolution of tumors under immune pressure. Its core mechanisms cover the immunogenic down-regulation of tumor cells and the immunosuppressive remodeling of the tumor microenvironment. There is controversy over the second-line treatment plan after first-line immune resistance. Currently, in clinical practice, personalized treatment strategies are mainly formulated based on factors such as the specific condition of the patient, physical condition, PD-L1 expression, driver gene mutation status, and previous treatment response. Second-line chemotherapy, targeted therapy, and immunotherapy are all optional strategies, and new drugs such as dual-immunotherapy and ADCs have also emerged one after another. This review mainly introduces different second-line treatment regimens for advanced NSCLC after first-line immune resistance. |
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