不同检测策略在预测非小细胞肺癌的PD1/PD-L1抑制剂临床疗效中的应用

近10年来,程序性死亡因子1(programmed death-1,PD-1)及其配体(programmed death ligand-1,PD-L1)的抑制剂在非小细胞肺癌(non-small cell lung cancer,NSCLC)的临床治疗中取得了重大突破,有望改变晚期NSCLC的治疗方式。然而,PD-1/PD-L1抑制剂在对NSCLC的治疗中需要借助有效的生物标志物以寻找受益人群(约20%～40%)。目前,临床上主要的判断标准是PD-L1的表达水平。本文综述了近年来在NSCLC中,与预测PD-1/PD-L1抑制剂疗效的PD-L1表达相关的检测方法,包括免疫组化、基于DNA/RNA水平检测、可溶性PD-L1的检测、正电子发射断层显像(positron emission tomography,PET)技术、多重免疫组化技术、流式细胞术和液体活检技术等,着重探讨了不同检测策略在评价PD-L1表达上的最新进展及应用前景,从而推动其在NSCLC免疫治疗中的临床应用。

Application of Different Detection Strategies in Predicting the Clinical Outcome of PD-1/PD-L1 Inhibitors in Non-small Cell Lung Cancer

The past decade has witnessed great breakthroughs for PD-1/PD-L1 inhibitors in non-small cell lung cancer (NSCLC), which was expected to improve the mode of treatment for advanced NSCLC patients. However, the most important problem facing clinical application is hunting for potent biomarkers to predict patients’ outcome, and so far, PD-L1 expression remains the main criteria. This review summarized the current progress on the detection of PD-L1 expression which was helpful in predicting clinical outcome of PD-1/PD-L1 inhibitors in advanced NSCLC, including immunohistochemistry (IHC), detection on DNA/RNA level, detection of soluble PD-L1, positron emission tomography(PET), multiple IHC, flow cytometry, liquid biopsy technique. Meanwhile, we discussed multiple strategies to optimize the evaluation of PD-L1 expression in this field, aiming to aid in the clinical application of immunotherapy in NSCLC.