非小细胞肺癌免疫治疗的研究进展

肺癌(lung cancer)是全球发病率及死亡率最高的恶性肿瘤之一,非小细胞肺癌(non-small cell lung cancer,NSCLC)占肺癌的85%,其五年生存率只有15%,传统的抗肿瘤治疗方法(手术、放疗和化疗等)在抑制肿瘤进展中的作用有限,即使有手术机会,也有40%以上患者出现局部复发或远处转移。目前多学科治疗较大程度提高了晚期NSCLC的生存期,研究表明,免疫治疗(immunotherapy)可改善肺癌的预后,有望成为肺癌的重要辅助治疗方式。其中,治疗性肿瘤疫苗(vaccination)如MAGE-A3、L-BLP25、Belagenpum atucel-L等、免疫检查点抑制剂(immune checkpoint inhibition)如ipilimumab、nivolumab、pembrolizumab等得到广泛关注。一系列临床试验表明免疫治疗可以使非小细胞肺癌的死亡率得到缓解,本文就其原理、临床试验、不良反应及有待解决问题的临床研究作系统综述。

Advances on Immunotherapy Research in Non-small Cell Lung Cancer

Lung cancer is the leading cause of cancer-related mortality and morbidity worldwide, non-small cell lung cancer (NSCLC) accounts for more than 85 % of lung cancer cases. The 5-year survival rate is only 15 %, traditional anti-cancer therapies (surgery, radiotherapy, and chemotherapy) have limited effectiveness in restraining progression. Even if they have a chance of operation, more than 40 %of them had local recurrence or distant metastasis. Currently multidisciplinary treatment greatly improves the survival of advanced NSCLC. Recent studies have demonstrated that immunotherapy which has advantages in the prognosis of lung cancer is expected to become the important adjuvant treatment for lung cancer. There is a wide attention on the vaccinations, such as MAGE-A3, L-BLP25, and Belagenpumatucel-L, and immune checkpoint inhibitions, such as ipilimumab, nivolumab, and pembrolizumab. A series of clinical trails show that immunotherapy can reduce the mortality of non-small cell lung cancer. The advances on the theory, clinical trails, toxicity and problems to be solved will be summarized in this review.