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老年晚期非小细胞肺癌免疫治疗策略OACSTPCD

Immunotherapy Strategy for Advanced Non-Small Cell Lung Cancer in the Elderly

中文摘要英文摘要

以免疫检查点抑制剂(ICIs)为代表的免疫治疗显著改变了非小细胞肺癌(NSCLC)患者的治疗现状,并已成为所有分期NSCLC的重要治疗手段,但有关老年晚期NSCLC患者的免疫治疗策略亟待进一步明确.通过评估临床研究中老年晚期NSCLC患者的生存数据,该文作者认为在体能状态(PS)评分<2 的老年晚期NSCLC患者中使用ICIs单药、ICIs双药联合、ICIs联合化学治疗等方案,能获得与年轻患者相近的生存获益和耐受性;但随着年龄继续增长(尤其是≥80 岁),疗效降低且免疫相关毒副反应发生率逐步增加,因此高龄晚期NSCLC患者应慎重选择ICIs治疗.此外,相较于年龄,PS评分才是导致患者无法接受免疫治疗以及较差生存结局的关键因素.总之,老年晚期NSCLC患者的免疫治疗极具挑战性,该领域仍有大量问题需要探索和解决.

Immunotherapy,represented by immune checkpoint inhibitors(ICIs),has significantly changed the treat-ment strategy of non-small cell lung cancer(NSCLC)and has become an important therapy for all stages of NSCLC.However,there is an urgent need for further clarification regarding ICIs for elderly patients with advanced NSCLC.Treatment strategies for ICIs were guided by assessing survival data of elderly NSCLC patients included in clinical trials.We concluded that treatment regi-mens such as ICI monotherapy,dual immunotherapy,and ICIs combined with chemotherapy could be carried out in elderly NSCLC patients with a performance status(PS)score<2.Elderly NSCLC patients treated with ICIs could achieve similar benefits as younger patients and are generally well tolerated.However,as age increases(especially above 80 years),the efficacy decreased and the incidence of immune-related adverse events(irAEs)gradually increased.Therefore,ICIs should be carefully selected for advanced NSCLC patients at an advanced age.Compared to age,PS was a key factor causing patients to be excluded from ICIs and poorer survival outcomes.In conclusion,immunotherapy in elderly patients with advanced NSCLC is extremely challenging,and many issues still need further exploration in this field.

尹佳鑫;宋羽霄;章必成

武汉大学人民医院肿瘤中心,武汉 430060

药学

免疫检查点抑制剂免疫治疗非小细胞肺癌/老年

Immune checkpoint inhibitorsImmunotherapyNon-small cell lung cancer/elderly

《医药导报》 2024 (003)

352-359 / 8

国家自然科学基金资助项目(82272928);希思科-BMS肿瘤免疫治疗研究基金资助项目(Y-BMS2019-003);武汉市科技局知识创新项目(2022020801010475).

10.3870/j.issn.1004-0781.2024.03.004

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