摘要
本文回顾了近年来国内外肺癌领域在多学科团队(multidisciplinary team,MDT)诊疗模式下的临床进展。在早期可切除非小细胞肺癌(non-small-cell lung cancer,NSCLC)的围手术期治疗中,术前新辅助联合术后辅助治疗的“夹心饼”模式,使患者生存获益。其中,国产特瑞普利单抗联合化疗显著提高了Ⅲ期可手术NSCLC的主要病理缓解率和无事件生存率,成为治疗围手术期NSCLC的新方案之一。在不可切除的晚期NSCLC患者中,根治性化疗后使用第三代表皮生长因子受体(epidermal growth factor receptor,EGFR)-酪氨酸激酶抑制剂(tyrosine kinase inhibitor,TKI)奥希替尼作为巩固治疗,改善了患者的无进展生存期,从靶向方面填补了精准治疗Ⅲ期肺癌的空白。此外,免疫治疗联合抗血管生成治疗可有效延长晚期NSCLC患者的总生存期。抗体偶联药物的研究进展迅速,国产药物如芦康沙妥珠单抗和瑞康曲妥珠单抗取得了相当的疗效。在广泛期小细胞肺癌(extensive-stage small-cell lung cancer,ES-SCLC)领域,靶向Delta样配体3(Delta-like ligand 3,DLL3)和分化簇3(cluster of differentiation 3,CD3)的双特异性抗体药物塔拉妥单抗疗效显著,已获美国食品药物管理局(Food and Drug Administration,FDA)加速批准用于ES-SCLC的二线治疗。
This review summarizes recent clinical progress in the field of lung cancer within the multidisciplinary team(MDT)diagnosis and treatment model across domestic and international studies.In the perioperative treatment of early-stage resectable non-small-cell lung cancer(NSCLC),the"sandwich"strategy combining preoperative neoadjuvant therapy with postoperative adjuvant therapy has demonstrated significant survival benefits for patients.Notably,domestic toripalimab combined chemotherapy significantly increases the major pathologic response(MPR)rate and event-free survival(EFS)rate of resectable stageⅢNSCLC patients,emerging as a novel treatment regimen for perioperative NSCLC.For unresctable NSCLC patients,consolidative therapy combined with osimertinib,a third-generation epidermal growth factor receptor-tyrosine kinase inhibitor,following radical chemotherapy has significantly extended progression free survival,filling the gap in targeted therapy for stageⅢlung cancer.Furthermore,the combination of immunotherapy and anti-angiogenic agents has effectively improved the overall survival of advanced NSCLC patients.Significant progress has also been made in the field of antibody-drug conjugates,with agents such as sacituzumab and trastuzumab demonstrating substantial therapeutic efficacy.In the field of extensive-stage small-cell lung cancer(ES-SCLC),the bispecific antibody tarlatamab targeting Delta-like ligand 3(DLL3)and cluster of differentiation 3(CD3)has exhibited significant efficacy,and has received accelerated approval from U.S.Food and Drug Administration(FDA)as a second-line treatment for ES-SCLC.
作者
龙贞莉
杨莹
虞永峰
陆舜
Long Zhenli;Yang Ying;Yu Yongfeng;Lu Shun(Shanghai Lung Cancer Center,Shanghai Chest Hospital,Shanghai Jiao Tong University,School of Medicine,Shanghai 200030,China)
出处
《实用肿瘤杂志》
2025年第4期293-305,共13页
Journal of Practical Oncology
基金
国家自然科学基金重点项目(82030045)
国家自然科学基金青年基金资助项目(82202924)。
关键词
肺癌
多学科团队
免疫治疗
靶向治疗
lung cancer
multidisciplinary team
immunotherapy
targeted therapy
