免疫检查点抑制剂在晚期NSCLC的一线治疗 研究进展

Research Progress of Immune Checkpoint Inhibitors in the First-Line Treatment of Advanced NSCLC

摘要: 肺癌在全球恶性肿瘤死亡率中占头位，是全世界男性癌症发病和死亡的重要原因，女性肺癌的发病率仅次于乳腺癌和结直肠癌，死亡率仅次于乳腺癌。我国是肺癌大国，全球将近一半的肺癌发病和死亡发生在我国。造成了严重的医疗负担。肺癌根据其病理特征，可以分为小细胞肺癌和非小细胞肺癌，而非小细胞肺癌(NSCLC)是常见的类型，在所有肺癌类型中占比可达80%。由于临床上早期NSCLC缺乏典型的症状和精准的检测方法，导致传统治疗(手术、化疗、放疗、靶向治疗)对晚期非小细胞肺癌患者的疗效有限。随着对肿瘤“免疫微环境(TME)”和“癌症免疫循环”机制的深入解析，免疫治疗已成为NSCLC治疗的核心手段之一。本综述旨在系统梳理免疫检查点抑制剂在晚期NSCLC的一线治疗进展、存在的挑战及未来展望。

Abstract: Lung cancer ranks first in the global malignant tumor mortality rate and is an important cause of male cancer incidence and death worldwide. The incidence of female lung cancer is second only to breast cancer and colorectal cancer, and the mortality rate is second only to breast cancer. China is a big country with lung cancer, and nearly half of the global lung cancer incidence and death occur in China, which caused a serious medical burden. According to its pathological characteristics, lung cancer can be divided into small cell lung cancer and non-small cell lung cancer, while non-small cell lung cancer (NSCLC) is a common type, accounting for up to 80% of all lung cancer types. Due to the lack of typical symptoms and accurate detection methods in early clinical NSCLC, the efficacy of traditional treatments (surgery, chemotherapy, radiotherapy, targeted therapy) in patients with advanced non-small cell lung cancer is limited. With the in-depth analysis of the mechanism of tumor “immune microenvironment (TME)” and “cancer immune cycle”, immunotherapy has become one of the core means of NSCLC treatment. This review aims to systematically sort out the progress, existing challenges and future prospects of immune checkpoint inhibitors in the first-line treatment of advanced NSCLC.