赵 琼.小细胞肺癌免疫治疗的研究进展[J].肿瘤学杂志,2017,23(9):754-758.
小细胞肺癌免疫治疗的研究进展
Research Progress on Immune Therapy for Small Cell Lung Cancer
投稿时间:2017-05-03  
DOI:10.11735/j.issn.1671-170X.2017.09.B003
中文关键词:  SCLC免疫治疗  临床研究
英文关键词:small cell lung cancer  immune therapy  clinical trial
基金项目:
作者单位
赵 琼 浙江大学医学院附属第一医院 
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中文摘要:
      摘 要:随着免疫2.0时代的到来,免疫治疗在肿瘤治疗中的认可度日益攀升,目前已开始广泛期(extensive-stage disease,ED)小细胞肺癌(small cell lung cancer,SCLC) 患者免疫治疗的初步研究。SCLC疫苗治疗在一路曲折中前行,并未给SCLC的治疗带来更多的曙光,疫苗联合化疗或许是SCLC治疗的一种有效的治疗手段。免疫检查点抑制剂从众多抗肿瘤研究中脱颖而出,取得了突破性进展,并且可能改变临床实践,包括以CTLA-4抑制剂和PD-1/PD-L1的抑制剂为主的单药及多药联合的临床研究。KEYNOTE-028研究的初步疗效和安全性结果:Pembrolizumab治疗广泛期SCLC在PD-L1阳性患者中有良好的抗癌活性,ORR可达 33%,中位随访期为9.8个月(4.1-NR),24例患者均发生了不良事件。因此美国国立综合癌症网络(National Comprehensive Cancer Network,NCCN)指南将Ipilimumab及Nivolumab推荐用于从治疗到复发<6个月的难治型患者(2A类)。在研的Ⅲ期临床试验Nivolumab对照化疗治疗经一线含铂化疗方案治疗后复发的SCLC的开放性、随机、Ⅲ期研究CheckMate 331以及PD-L1抑制剂Atezolizumab+卡铂+依托泊苷治疗广泛期SCLC 的 Ⅲ期研究IMpower133正在开展当中。这些研究结果将确立免疫治疗在ES-SCLC二线治疗的地位。同时寻找能够预测可从免疫治疗中获益的生物标记物将推动这一领域的发展。
英文摘要:
      Abstract:With the coming era of immune-therapy,immune therapy is becoming increasingly important. Several clinical trials of immune-therapy were conducted in extensive-stage small cell lung cancer (SCLC). The development process of vaccine therapy in SCLC is long and full of changes,vaccine combined chemotherapy maybe an effective treatment for SCLC. Checkpoint inhibitors have now been launched for clinical treatment of SCLC,and is expected to bring new vision to the treatment of SCLC. KEYNOTE-028 indicated that pembrolizumab is effective in SCLC patients with PD-L1 expression. ORR was 33% in this study in the 9.8 months median follow-up time. Hence,ipilimumab and nivolumabthe were recommended for refractory SCLC patients by a current National Comprehensive Cancer Network guideline(2A). Several phase Ⅲ trials are ongoing,including checkmate 331 and IMpower133,these findings will establish the status of immunotherapy in the second-line treatment of ES-SCLC. Moreover,we are looking forwaward of further researches on potential predictive biomarkers of immunotherapy.
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