| 柏伟宣,刘孟宇.非小细胞肺癌免疫治疗后超进展：从机制探索到临床管理的挑战[J].肿瘤学杂志,2026,32(6):479-485. |
| 非小细胞肺癌免疫治疗后超进展：从机制探索到临床管理的挑战 |
| Hyperprogressive Disease in Non-Small Cell Lung Cancer Immuno-therapy： from Mechanisms to Clinical Management |
| 投稿时间：2026-04-14 |
| DOI：10.11735/j.issn.1671-170X.2026.06.B005 |
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| 中文关键词: 癌，非小细胞肺 免疫检查点抑制剂 超进展 肿瘤微环境 生物标志物 临床管控 |
| 英文关键词:carcinoma, non-small cell lung immune checkpoint inhibitor hyperprogressive disease tumor microenvironment biomarker clinical management |
| 基金项目:国家重点研发计划（2024YFC3505501）；中国中医科学院重点实验室培育专项（ZB2025011）；中国中医科学院“中国中医药联合研究生院”科教专项（CI2025C012LH） |
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| 摘要点击次数: 5 |
| 全文下载次数: 1 |
| 中文摘要: |
| 摘 要：免疫检查点抑制剂的运用显著改善了非小细胞肺癌（non-small cell lung cancer，NSCLC）患者的生存预后，但部分患者治疗后出现的超进展（hyperprogressive disease，HPD）现象构成了严峻的临床挑战，其表现为在接受免疫治疗后肿瘤加速增殖，导致预后急剧恶化。全文旨在系统整理此领域的现状与问题，通过梳理HPD定义、诊断指标以及NSCLC患者发生HPD的高风险相关特征因素，进而分析包括肿瘤驱动基因、免疫微环境重塑、宿主免疫状态及治疗相关要素在内的潜在生物学机制；并在此基础上概述了当前用于预测和早期识别HPD标志物的研究进展，探讨面向HPD患者的临床管理办法，同时强调了治疗方案的适时调整与个性化预测干预的重要性，旨在为优化NSCLC患者免疫诊疗策略、规避HPD发生风险提供思路参考。 |
| 英文摘要: |
| Abstract： Immune checkpoint inhibitor have significantly improved the survival outcomes of patients with non-small cell lung cancer(NSCLC). However， a subset of patients experiences hyperprogressive disease (HPD)， a paradoxical phenomenon characterized by accelerated tumor growth after immunotherapy， leading to rapid clinical deterioration and poor prognosis. This review systematically examines the current state and challenges in this field by summarizing the definitions， diagnostic criteria， and high-risk characteristics of HPD in NSCLC patients. It further analyzes potential biological mechanisms， including tumor driver genes， immune microenvironment remodeling， host immune status， and treatment-related factors. On this basis， the review outlines recent progress in biomarkers for predicting and early identifying HPD， evaluates clinical management strategies for patients with HPD， and emphasizes the importance of timely treatment adjustment and personalized predictive interventions. Finally， future research directions are discussed， aiming to provide insights for optimizing immunotherapy strategies and minimizing the risk of HPD in NSCLC patients. |
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