放免联合时序在非小细胞肺癌中的研究进展
摘要
长了部分患者的生存期。然而，随着治疗的推进，放疗和免疫治疗的时序问题存在争议，同时考虑不良反应的叠加，
适用人群的筛选，及放射线最佳剂量的确定等问题。放疗和免疫联合治疗具有双面性[2]，一方面可激活并产生抗肿
瘤免疫促进效应，另一方面也可能产生免疫抑制作用。本文系统总结了NSCLC放疗联合免疫治疗的时序，相互作用
的机制，放疗的最佳治疗剂量。未来需通过大规模临床试验进行验证，同时除了联合治疗带来的疗效外，我们更应
该注意联合治疗对肺部的影响。通过放疗与免疫治疗联合协同作用的基础与临床研究最新进展进行系统综述，以期
为放疗联合免疫治疗的理论基础发展与临床实践进步提供参考[3]。
关键词
全文:
PDF参考
[1]Hendriks, L.E.L., et al., Non-small-cell lung cancer.
Nat Rev Dis Primers, 2024. 10(1): p. 71.
[2]Burr, J.L., et al., Combination Immunotherapy With
Radiotherapy in Non-Small Cell Lung Cancer: A Review of
Evidence. Cancer Med, 2024. 13(21): p. e70402.
[3]Wang, W., et al., CD8(+) T cells regulate tumour
ferroptosis during cancer immunotherapy. Nature, 2019.
569(7755): p. 270-274.
[4]Wrona, A., Role of immunotherapy in stage III
nonsmall cell lung cancer. Curr Opin Oncol, 2019. 31(1): p.
18-23.
[5]Rajappa, S., S. Sharma, and K. Prasad, Unmet
Clinical Need in the Management of Locally Advanced
Unresectable Lung Cancer: Treatment Strategies to Improve
Patient Outcomes. Adv Ther, 2019. 36(3): p. 563-578.
[6]Melosky, B., et al., Immune checkpoint-inhibitors
and chemoradiation in stage III unresectable non-small cell
lung cancer. Lung Cancer, 2019. 134: p. 259-267.
[7]Liguori, L., et al., Checkpoint based immunotherapy
in non-small cell lung cancer: a real-world retrospective
study. Front Immunol, 2024. 15: p. 1419544.
[8]Sun, C., et al., METTL14 regulates CD8(+)T-cell
activation and immune responses to anti-PD-1 therapy in
lung cancer. World J Surg Oncol, 2024. 22(1): p. 128.
[ 9 ] T s u k i t a , Y . , e t a l . , I m m u n o t h e r a p y o r
Chemoimmunotherapy in Older Adults With Advanced
Non-Small Cell Lung Cancer. JAMA Oncol, 2024. 10(4): p.
439-447.
[10]Bao, Y., et al., BIBR1532 combined with
radiotherapy induces ferroptosis in NSCLC cells and activates
cGAS-STING pathway to promote anti-tumor immunity. J
Transl Med, 2024. 22(1): p. 519.
[11]Zboralski, D., et al., Fibroblast activation protein
targeted radiotherapy induces an immunogenic tumor
microenvironment and enhances the efficacy of PD-1
immune checkpoint inhibition. Eur J Nucl Med Mol
Imaging, 2023. 50(9): p. 2621-2635.
[12]Wang, H., et al., Preclinical study and phase II trial
of adapting low-dose radiotherapy to immunotherapy in
small cell lung cancer. Med, 2024. 5(10): p. 1237-1254.e9.
[13]Nassar, A.H., et al., Consolidation Osimertinib
Versus Durvalumab Versus Observation After Concurrent
Chemoradiation in Unresectable EGFR-Mutant NSCLC:
A Multicenter Retrospective Cohort Study. J Thorac Oncol,
2024. 19(6): p. 928-940.
[14]Guan, J., et al., A Phase 2 Study of In Situ Oncolytic
Virus Therapy and Stereotactic Body Radiation Therapy
Followed by Pembrolizumab in Metastatic Non-Small Cell
Lung Cancer. Int J Radiat Oncol Biol Phys, 2024. 118(5): p.
1531-1540.
[15]Zhao, Z.R., et al., Stereotactic body radiotherapy
with sequential tislelizumab and chemotherapy as neoadjuvant
therapy in patients with resectable non-small-cell lung cancer
in China (SACTION01): a single-arm, single-centre, phase
2 trial. Lancet Respir Med, 2024. 12(12): p. 988-996.
[16]Donlon, N.E., et al., Radiotherapy, immunotherapy,
and the tumour microenvironment: Turning an
immunosuppressive milieu into a therapeutic opportunity.
Cancer Lett, 2021. 502: p. 84-96.
[17]Trapé, J., et al., Variations in tumor growth, intraindividual biological variability, and the interpretation of
changes. Clin Chem Lab Med, 2024. 62(8): p. 1618-1625.[18]Yan, X., et al., Efficacy and safety analysis of immune
checkpoint inhibitor rechallenge therapy in locally advanced
and advanced non-small cell lung cancer: a retrospective
study. J Thorac Dis, 2024. 16(3): p. 1787-1803.
[19]Borges, F. and A.D. Garg, An Immunometabolic
Route for Activating cGAS/STING to Drive Anticancer
Immunity. Cancer Res, 2024. 84(16): p. 2569-2571.
[20]Purbey, P.K., et al., Opposing tumor-cell-intrinsic
and -extrinsic roles of the IRF1 transcription factor in
antitumor immunity. Cell Rep, 2024. 43(6): p. 114289.
[21]Heinzerling, J.H., et al., Primary lung tumour
stereotactic body radiotherapy followed by concurrent
mediastinal chemoradiotherapy and adjuvant immunotherapy
for locally advanced non-small-cell lung cancer: a multicentre,
single-arm, phase 2 trial. Lancet Oncol, 2025. 26(1): p. 85-97.
[22]Zhou, R., et al., Fraction Dose Escalation
of Hypofractionated Radiotherapy with Concurrent
Chemotherapy and Subsequent Consolidation Immunotherapy
in Locally Advanced Non-Small Cell Lung Cancer: A Phase
I Study. Clin Cancer Res, 2024. 30(13): p. 2719-2728.
[23]Zhang, Y., et al., The AST/ALT ratio predicts
survival and improves oncological therapy decisions in patients
with non-small cell lung cancer receiving immunotherapy with
or without radiotherapy. Front Oncol, 2024. 14: p. 1389804.
[24]Zhou, Q., et al., GEMSTONE-301: a phase III
clinical trial of CS1001 as consolidation therapy in patients
with locally advanced/unresectable (stage III) non-small cell
lung cancer (NSCLC) who did not have disease progression
after prior concurrent/sequential chemoradiotherapy. Transl
Lung Cancer Res, 2020. 9(5): p. 2008-2015.
[25]K, J.S., et al., Pembrolizumab Plus Concurrent
Chemoradiation Therapy in Patients With Unresectable,
Locally Advanced, Stage III Non-Small Cell Lung Cancer:
The Phase 2 KEYNOTE-799 Nonrandomized Trial. JAMA
oncology, 2021.
[26]Rothschild, S.I., et al., SAKK 16/14: Durvalumab
in Addition to Neoadjuvant Chemotherapy in Patients
With Stage IIIA(N2) Non-Small-Cell Lung Cancer-A
Multicenter Single-Arm Phase II Trial. J Clin Oncol, 2021.
39(26): p. 2872-2880.
[27]Li, C., et al., ATM inhibition enhance
immunotherapy by activating STING signaling and augmenting
MHC Class I. Cell Death Dis, 2024. 15(7): p. 519.
[28]Zhang, D. and A. Rohatgi, Improving survival for
patients with metastatic non-small cell lung cancer in the
immunotherapy era. Cancer, 2025. 131(1): p. e35675.
[29]Meyer, M.L., et al., New promises and challenges
in the treatment of advanced non-small-cell lung cancer.
Lancet, 2024. 404(10454): p. 803-822.
[30]叶蓉，乐雯雯，张晨，等.晚期非小细胞肺癌患
者二线化疗联合免疫治疗与单一化疗的疗效观察[J].徐州
医科大学学报，2025，45（01）：63-67.
Refbacks
- 当前没有refback。
