免疫治疗在非小细胞肺癌治疗领域的应用

肺癌是全球范围内发病率排名第二的癌症,对人类身体健康造成了严重威胁。手术与放化疗是治疗肺癌的传统方案,虽具有一定的作用,但也存在诸如不良反应大、对患者耐受度要求较高、根治率低、易发生微小病灶转移等问题。近年来,随着各类免疫治疗方案出现,免疫检查点抑制剂的研发,免疫治疗这一全新思路也以单药治疗、联合化疗以及双药联合的新辅助免疫治疗形势被逐步应用于非小细胞肺癌（non-small cell lung cancer, NSCLC）的治疗,展现出明显优于传统治疗方案的治疗效果。本综述聚焦于非小细胞肺癌的免疫检查点抑制剂新辅助免疫治疗,从新辅助免疫治疗的各个应用角度出发全面探讨这一全新治疗思路对于治疗非小细胞肺癌的优势和重要意义。     

肺癌免疫治疗标志物研究进展认识

正肺癌是我国发病率和死亡率最高的恶性肿瘤。目前临床对于晚期肺癌的治疗,仍以靶向治疗和放化疗为主。但近年来随着免疫治疗的快速发展,由此开创了晚期肺癌新的治疗方案,也引领了整个晚期肺癌治疗的变革,给患者带来了新希望。以程序性死亡受体1(programmed cell death protein 1,PD-1)抑制剂为代表的免疫治疗问世,打破了恶性肿瘤既往治疗僵局,特别在晚期肺癌患者中取得了空前     

非小细胞肺癌免疫治疗相关循环生物标志物研究进展

非小细胞肺癌(NSCLC)是肺癌的最常见类型, 免疫治疗目前已经成为NSCLC较为常用的治疗方法。利用生物标志物筛选出免疫治疗高获益人群, 及时掌握NSCLC患者治疗效果信息, 可帮助应对当前免疫治疗遇到的挑战。循环生物标志物与传统的标志物如抗程序性死亡受体蛋白1(PD-L1)表达分数等相比, 具有无创、取材方便的特点, 而且可在免疫治疗过程中动态地评估患者预后以及观察患者免疫治疗疗效, 具有广阔的应用前景。     

131Ⅰ-chTNT放射免疫联合微波消融术综合治疗晚期肺癌

肺癌的治疗一直是采取手术、化疗、放疗,近年来靶向治疗、治疗性抗体、放射免疫治疗、介入治疗等新的治疗手段的应用,使肺癌综合治疗的疗效进一步提高。微创技术的发展,使     

131I-chTNT放射免疫联合微波消融术综合治疗晚期肺癌

肺癌的治疗一直是采取手术、化疗、放疗,近年来靶向治疗、治疗性抗体、放射免疫治疗、介入治疗等新的治疗手段的应用,使肺癌综合治疗的疗效进一步提高.微创技术的发展,使得射频消融、微波消融、冷冻消融等技术得以逐步应用于肿瘤临床,其中以微波消融最为前沿.针对肿瘤变性坏死细胞的131I-肿瘤细胞核人鼠嵌合单克隆抗体(131I-chTNT)已开始在临床应用,这是全球首个肺癌放射免疫治疗药物.     

晚期肺癌免疫治疗现状及影像学疗效评价和预测

免疫治疗是近年新兴的治疗手段,为部分传统治疗疗效不佳的肿瘤患者提供新的治疗思路,已成为部分晚期肺癌患者的一线治疗方案。目前,实体瘤疗效评价标准(response evaluation criteria in solid tumors, RECIST)仍是实体瘤疗效评价的主流标准。但免疫治疗因其治疗反应的特殊性,传统RECIST评估不能及时准确评价肿瘤治疗疗效。而影像学成像已进入功能化成像新时代,可提供微观分子及代谢改变信息。人工智能与放射影像组学通过挖掘图像背后更多的数学规律,可提供更多具有诊断价值的信息,有望为肺癌免疫治疗的疗效评价与预测提供新方法和新思路。本文就晚期肺癌免疫治疗的机制、现状及评价标准作一综述,重点分析影像学疗效评价与预测,并对其作出展望。     

嵌合抗原受体基因修饰T细胞免疫疗法在肺癌治疗中的研究进展

肺癌是全世界所有癌症中发病率和病死率最高的恶性肿瘤之一，目前仍缺乏较好的治疗手段。嵌合抗原受体基因修饰T(CAR-T)细胞免疫疗法作为一种新的治疗方法在血液系统恶性肿瘤中疗效显著，也为肺癌等实体肿瘤的免疫治疗开辟了新途径。然而，由于实体瘤的异质性、肿瘤微环境免疫抑制、肿瘤靶抗原逃逸及脱靶毒性等问题，造成CAR-T细胞免疫疗法在肺癌治疗中的应用存在挑战和障碍。本文总结了CAR-T细胞免疫疗在肺癌治疗中的最新研究进展，包括CAR-T细胞生物学特征、靶点选择、早期临床研究和治疗不良反应，并提出肺癌CAR-T细胞免疫疗法的优化策略，旨在为肺癌的临床免疫治疗提供新思路。     

非小细胞肺癌免疫检查点抑制剂治疗进展

肺癌是全球范围内发病率及死亡率极高的恶性肿瘤,其中以非小细胞肺癌(non-small cell lung cancer,NSCLC)最为常见。NSCLC的传统治疗主要依靠化学药物,近年来免疫治疗成为NSCLC治疗的热点,并取得了令人瞩目的进展。大量新型生物免疫制剂被开发并应用于临床,其中免疫检查点抑制剂的应用最广、疗效最为肯定。本文将对近年NSCLC免疫治疗生物标志物研究现状及进展进行阐述,以期提高免疫治疗精准度,更好地指导NSCLC患者的个体化治疗。     

冷冻消融联合免疫治疗在非小细胞肺癌治疗中的应用进展

冷冻消融在非小细胞肺癌（non-small cell lung cancer,NSCLC）的治疗中除了通过低温使肿瘤细胞脱水、破裂、坏死外，还可通过产生抗肿瘤免疫应答来发挥作用的。而近年来免疫治疗在NSCLC的治疗方面效果显著。那么冷冻消融和免疫治疗在NSCLC治疗方面是否具有协同作用呢？本文就冷冻治疗、免疫治疗及两种联合治疗在NSCLC治疗中的应用进展作一综述。     

中西医结合治疗老年肺癌的优势分析

目前肺癌常用的治疗手段有手术、化疗、放疗、靶向治疗、生物免疫治疗。但是,并非所有肺癌患者均有条件接受目前常用的治疗手段。肺癌的发病率由40岁开始升高,70岁左右达到高峰。超过1／3的肺癌患者是〉70岁的老年人。由于高龄肺癌患者往往同时合并其他慢性疾病,加之经济条件的限制,对老年肺癌患者采用针对全身兼顾局部的综合治疗方案被认为是最佳的治疗模式。     

Advances in diagnosis and treatment of lung cancer

Advances in diagnostic methods and treatment modalities for lung cancer in the recent years were reviewed. Computed tomograph and other lung imaging devices facilitated early detection of small nodule, or diagnosis of extension of cancer. In addition to bronchofiberscopy, fluorescence endoscopy, tracheo-bronchial stenting, or photodynamic therapy brought marked advances in diagnosis as well as treatment of lung cancer at hilar and peripheral regions. Most of the comparative study to evaluate postoperative adjuvant therapy showed negative results. However, it is expected that induction therapy will improve surgical result of advanced lung cancer. Surgery for lung cancer showed great improvements in terms of operative mortality, operative methods (bronchoplastic surgery, combined resection of adjacent organ invasion, extensive lymph node dissection, or limited lung resection) and surgical outcome.     

肺癌靶向治疗多次耐药后再次选择的成功报道

分子靶向治疗已有20多年的发展史,在治疗肺癌这方面作用亦是非常显著,明显延长了晚期非小细胞肺癌患者的生存期,尤其是无进展生存期。但是靶向治疗也有不足之处,在治疗一段时间后大部分患者会出现耐药,需多次行基因检测,寻找新的突变指导下一步耐药的靶向治疗。作者分享了1例非小细胞肺癌靶向治疗多次耐药患者的治疗经过,并分析总结了经验。     

肺癌治疗药物的现状及展望

肺癌是最常见的恶性肿瘤,对于那些已失去手术机会的晚期肺癌患者,药物治疗是其主要的治疗手段,也是其最后的希望。本文主要从肺癌化疗药物、靶向药物治疗的现状及肺癌治疗药物进展三个方面对肺癌治疗药物作一概述。     

肺干细胞、肺癌干细胞与肺癌

背景:随着肿瘤干细胞理论的出现,近年来通过杀死肿瘤干细胞而治疗肿瘤的研究逐渐兴起,并取得一定的进展。目的:综述肺干细胞、肺癌干细胞及肺癌的研究进展。方法:应用计算机检索中国全文期刊数据库及PubMed相关文献,检索词分别为"肺癌干细胞、肺癌、肺干细胞","lung stem cell,lung cancer stem cell,lungcancer,cancer stem cell",并限定语言为英语和中文,最终入选32篇文章进行综述。结果与结论:肺癌干细胞可能起源于正常肺组织干细胞,而肺癌干细胞可能是肺癌发生的重要因素。随着对肺癌干细胞研究的深入,肺癌治疗将会进入一个崭新的阶段。     

EGFR-TKI在EGFR突变非小细胞肺癌治疗中的应用现状及进展

表皮生长因子受体(EGFR)突变是非小细胞肺癌(NSCLC)中最常见的致癌驱动因素.表皮生长因子受体-酪氨酸激酶抑制剂(EGFR-TKI)广泛应用于肺癌治疗中,特别是晚期NSCLC的一线治疗,与标准化疗相比,EGFR-TKI单药治疗已获得较好的疗效及耐受性.而EGFR-TKI在新辅助治疗、辅助治疗及晚期一线与其他药物联...     

Small cell lung cancer

Lung cancer is the most common cause of cancer death in the United States, with approximately 135,000 men and women dying each year. While much has been learned about the etiologic risk factors, less progress has been made in therapy. Five-year survival rates remain at less than 10%. However, there has been some progress in the therapy of one histological subtype of lung cancer, small cell lung cancer. Totaling around 20% of lung cancer cases, small cell lung cancer is distinct from the other histologic subtypes in its biologic behavior and responsiveness to therapy. In the 1960s, the median survival for patients with small cell lung cancer was approximately 3 months. With combination chemotherapy and radiotherapy median survivals now range from 1 to 2 years, and there is evidence for a curative potential since approximately 10% of patients who initially present with limited disease survive greater than 2 years. The unique clinical aspects of this histological subtype potentially relate to its underlying cell of origin. This behavior is reflected in the numerous paraneoplastic syndromes that frequently accompany small cell lung cancer. Its propensity for early dissemination have made staging the extent of disease an important part of the clinical evaluation. Since small cell lung cancer is sensitive to both chemotherapy and radiation therapy, there have been multiple clinical trials evaluating drug/radiotherapy combinations. This article will briefly describe the unique aspects of small cell lung cancer as opposed to other histological subtypes of lung cancer and give an overview of the current clinical approach and treatment of this disease.     

影像组学在支气管肺癌中的应用进展

肺癌是发病率和死亡率最高的恶性肿瘤之一。手术切除是早期肺癌最重要的治疗手段。对于晚期肺癌,除新辅助化疗及放疗外,靶向治疗及免疫治疗逐渐广泛应用。因此,肺癌的早期诊断及个体化治疗方案的制定有重要意义。影像组学作为新兴的图像定量分析方法,可更客观准确地定量表征病变的细微结构,从而达到疾病诊断、肿瘤分级分期、疗效评估和预后预测等目的。本文就CT影像组学在肺癌诊治中的应用展开综述。     

关于老年非小细胞肺癌治疗的几点思考

目的：老年肺癌的发病在逐渐地增加,特别是非小细胞肺癌,但研究老年肺癌和接受治疗老年肺癌偏少,目前对老年肺癌的治疗多从回顾性研究得出的结论。老年肺癌手术治疗时,充分考虑到患者的术前功能状态尤其是心肺功能状态和合并症,微创的手术老年患者更合适。对于老年患者器官储备功能的降低和合并症多,对化疗的耐受能力降低,化疗能否给患者带来生存好处,采取单药还是双药化疗是临床讨论的问题还需要进一步研究。老年容易发生放射行肺炎和放射行食管炎,放疗时老年患者具有与年轻人不同的耐受量和体积当接受。对老年周围性肺癌放疗取得良好效果,对老年中央型肺癌采用调强或适形放疗多野放疗会增加了放射行肺炎的可能性,是否带来生存好处还没有被证实。靶向治疗药物的毒副反应较小,但其费用高反应率低,仅少数患者能够得到治疗好处。对于咳血症状比较明显的,可采用介入治疗。总之,对老年非小细胞肺癌患者治疗前需要进行全面的老年评估,还需要更多研究。     

Pulmonary complications of cancer therapy.

Significant improvements in the result of cancer treatment have resulted in longer survival for many of these patients and increasing numbers of patients who are cured. Unfortunately, the toxic effect of cancer therapy on other organs, and particularly the lung, has become an increasingly recognized problem in these patients. There are no specific tests that are diagnostic for chemotherapy or radiation-induced lung injury so the clinician must keep this diagnosis in mind and attempt to evaluate other possibilities. If treatment induced lung injury is considered likely, whether radiation pneumonitis or drug-induced pneumonitis, corticosteroid therapy may be of benefit. Therapy should be initiated at high doses and then tapered slowly following the clinical response. Most of these patients will do well, however, pulmonary toxicity may lead to respiratory impairment or mortality in some patients. Hopefully, as we gain more understanding of the risk factors and mechanisms of treatment-induced lung toxicity, new methods will be developed to decrease lung impairment due to cancer treatment.     

Second-line chemotherapy and beyond for non-small-cell lung cancer

Platinum-based chemotherapy is now established in the treatment of all stages of lung cancer. Despite the benefits of therapy, the majority of patients treated for lung cancer will ultimately progress. Some will retain good performance status and be candidates for additional, tumor-directed treatment. Docetaxel and pemetrexed have documented activity in phase III trials in patients progressing after first-line, platinum-based therapy. Gefitinib has recently been approved for treatment of disease in the third line. Numerous other agents with diverse mechanisms are currently undergoing evaluation in this setting. This review evaluates the population eligible for such treatments and discusses recent trials in second and subsequent lines of therapy.