| 杨东晓,黄观斌,陈华林,等.驱动基因阴性非小细胞肺癌一线免疫治疗联合化疗后治疗的研究进展[J].肿瘤学杂志,2026,32(3):175-184. |
| 驱动基因阴性非小细胞肺癌一线免疫治疗联合化疗后治疗的研究进展 |
| Research Progress on Treatment Strategies for Driver Gene-Negative Non-Small Cell Lung Cancer After Resistance to First-Line Immune-Chemotherapy |
| 投稿时间：2025-05-20 |
| DOI：10.11735/j.issn.1671-170X.2026.03.B001 |
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| 中文关键词: 非小细胞肺癌 驱动基因 免疫治疗 耐药 药物疗法 |
| 英文关键词:non-small cell lung cancer driver gene immunotherapy drug resistance durg therapy |
| 基金项目:国家自然科学基金（82473392） |
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| 摘要点击次数: 32 |
| 全文下载次数: 10 |
| 中文摘要: |
| 摘 要：对于驱动基因阴性晚期非小细胞肺癌（non-small cell lung cancer，NSCLC）患者，一线治疗已确立以免疫检查点抑制剂联合化疗为基础的模式，虽显著改善了患者预后，但治疗耐药所导致的疾病进展仍是临床面临的严峻挑战。全文旨在系统梳理该领域的研究进展。首先，从肿瘤细胞内在机制与肿瘤微环境重塑等方面，剖析了NSCLC对免疫治疗产生原发性及继发性耐药的核心原因，为克服耐药提供理论依据。在此基础上，重点综述二线治疗的多元化探索：其一，回顾了单药化疗、抗血管生成药物联合化疗等传统方案的当前定位与疗效；其二，探讨了免疫再挑战治疗模式的适用人群及潜在价值；其三，着重阐述了抗体药物偶联物在克服耐药中的突破性进展与应用前景；其四，分析了双免疫联合治疗等新型组合策略的探索与挑战。驱动基因阴性NSCLC一线免疫治疗联合化疗后的治疗策略正趋向于精准化与个体化。未来的临床决策需综合考量患者的疾病进展模式、既往治疗反应及生物标志物状态，从而在多元化方案中形成最优的治疗序列，最终惠及患者。 |
| 英文摘要: |
| Abstract： For patients with advanced non-small cell lung cancer (NSCLC) driver gene-nagative， first-line treatment based on immune checkpoint inhibitors combined with chemotherapy has significantly improved prognosis. However， disease progression due to treatment resistance remains a major clinical challenge. This review systematically summarizes recent advances in this field. Firstly， the core mechanisms for primary and secondary resistance to immunotherapy in NSCLC were analyzed， focusing on tumor-intrinsic factors and tumor microenvironment remodeling， providing a theoretical basis for overcoming resistance. On this basis， diverse second-line treatment strategies were comprehensively reviewed: Firstly， the current role and efficacy of traditional options such as single-agent chemotherapy and anti-angiogenic drugs combined with chemotherapy were reviewed. Secondly， the applicable population and potential value of the immune rechallenge treatment mode were discussed. Thirdly， the breakthrough progress and application prospects of antibody-drug conjugates in overcoming drug resistance were emphasized. Fourthly， the exploration and challenges of new combination strategies such as dual immunotherapy were analyzed. Current evidence indicates that post-resistance treatment strategies for driver gene-negative NSCLC are increasingly shifting towards precision and individualization. Future clinical decision-making should integrate multiple factors， including the pattern of disease progression， prior treatment response， and biomarker status， to optimize the treatment sequence among various options and ultimately improve patient outcomes. |
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