医学
彭布罗利珠单抗
阿替唑单抗
无容量
杜瓦卢马布
易普利姆玛
肿瘤科
内科学
免疫疗法
临床试验
阿维鲁单抗
肺癌
癌症
作者
Francesco Gelsomino,Giuseppe Lamberti,Claudia Parisi,Laura Casolari,Barbara Melotti,Francesca Sperandi,Andrea Ardizzoni
标识
DOI:10.1016/j.ctrv.2019.08.003
摘要
Small cell lung cancer (SCLC) was defined as a "recalcitrant cancer" because of its dismal prognosis and lack of outcome improvements in the last 30 years. Immunotherapy with checkpoint inhibitors revolutionized treatment in many cancer types and results from the IMpower133 study, a double-blind placebo-controlled phase III trial, showed overall survival benefit for atezolizumab when added to standard platinum-etoposide chemotherapy in first-line SCLC setting for the first time since years. Trials with other checkpoint inhibitors, e.g. pembrolizumab, durvalumab, nivolumab and ipilimumab, are ongoing in various settings, but, to date, there are no defined factors to identify patients who are more likely to benefit from such treatments. This review summarizes results of immunotherapy trials in SCLC for first-line, maintenance and further-line therapies for single-agents and combinations with checkpoint inhibitors. Predictive factors from these trials are reviewed in order to identify their clinical value, with particular emphasis on PD-L1 expression on both tumor cells and in stroma, especially in pembrolizumab-treated patients, and tumor mutational burden, for patients treated with the ipilimumab and nivolumab combination.
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