摘要
肺癌是全球癌症相关死亡的首要原因,其中约40%为非小细胞肺癌(NSCLC)驱动基因阴性型。该类肿瘤缺乏有效的靶向治疗手段,目前主要依赖化疗、免疫检查点抑制剂(ICI)及其联合治疗方案。近年来,免疫治疗显著改善了患者的生存结局,已成为一线标准治疗的重要组成部分,但仍面临原发耐药等突出挑战,研究热点逐渐转向新型ICIs及双特异性抗体等策略,旨在逆转肿瘤免疫抑制微环境。同时,抗体药物偶联物(ADC)及免疫治疗联合抗血管生成药物等新型治疗模式也显示出优于传统方案的潜力。在治疗技术方面,包括个体化疫苗、溶瘤病毒及CAR-T疗法在内的多种生物治疗方法已在早期临床研究中展现出抗肿瘤活性。未来研究应致力于深入解析耐药机制、筛选有效生物标志物,并构建多学科全程化管理体系,从而进一步优化驱动基因阴性晚期肺癌患者的治疗策略。
Lung cancer remains the foremost cause of cancer-related mortality worldwide,with approximately 40%of adenocarcinoma cases lacking identifiable driver genes and effective targeted therapies.Consequently,chemotherapy,immune checkpoint inhibitors and their combination regimens constitute the primary therapeutic approaches.In recent years,immunotherapy has markedly enhanced patient survival rates and has been established as a standard first-line treatment.However,issues of primary resistance remain significant.Current research has increasingly focused on novel immune checkpoints and bispecific antibodies,which aim to reverse the immunosuppressive tumor microenvironment.Furthermore,the combination treatment strategy of immunotherapy plus anti-angiogenesis and antibody-drug conjugates has demonstrated superiority over traditional regimens.In the area of technological innovation,emerging biological treatment modalities,including personalized vaccines,oncolytic viruses and CAR-T cell therapy,have shown promising antitumor activity in advanced clinical trials.Future efforts should prioritize the elucidation of resistance mechanisms,the identification of biomarkers,and the implementation of multidisciplinary comprehensive management to further refine and optimize the therapeutic landscape.
作者
王智
董晓荣
WANG Zhi;DONG Xiaorong(Cancer Center,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,430022,Hubei,China;Hubei Key Laboratory of Precision Radiation Oncology,Wuhan,430022,Hubei,China;Institute of Radiation Oncology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,430022,Hubei,China)
出处
《肿瘤药学》
2025年第5期572-581,F0002,共11页
Anti-Tumor Pharmacy
基金
国家自然科学基金面上项目(82273323)。
关键词
非小细胞肺癌
驱动基因阴性
免疫治疗
免疫检查点抑制剂
Non-small cell lung cancer
Driver gene negative
Immunotherapy
Immune checkpoint inhibitor
