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广泛期小细胞肺癌的免疫治疗进展
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| 篇名： | 广泛期小细胞肺癌的免疫治疗进展 |
| TITLE： | Progress in immunotherapy for extensive-stage small cell lung cancer |
| 摘要： | 小细胞肺癌是一种高度侵袭性肺癌亚型，多数患者确诊时已处于广泛期小细胞肺癌（ES-SCLC）阶段。传统治疗方案缓解持续时间有限，多数患者在治疗后短期内易复发或发生进展，长期生存率仍较低。然而，免疫治疗改变了ES-SCLC的治疗格局。本文综述ES-SCLC一线免疫联合化疗、维持治疗、疾病进展后治疗的研究进展，发现程序性死亡受体1/程序性死亡配体1（PD-1/PD-L1）抑制剂联合铂类/依托泊苷是ES-SCLC一线治疗的重要基础，PD-1/PD-L1抑制剂联合抗血管生成治疗、双免疫检查点抑制剂联合铂类/依托泊苷具有一定应用前景，但其额外获益尚未明确。维持治疗中，芦比替定联合阿替利珠单抗已获得Ⅲ期临床研究阳性证据，tarlatamab联合PD-L1抑制剂等维持方案仍需进一步验证。对于一线免疫联合化疗后进展患者，靶向δ样配体3/分化簇3的T细胞衔接器tarlatamab已显示生存获益，靶向B7同源物3、滋养层细胞表面抗原2的抗体偶联药物亦表现出一定抗肿瘤活性。未来，ES-SCLC免疫治疗仍需进一步明确不同治疗阶段的最佳联合模式、治疗顺序及优势人群。 |
| ABSTRACT： | Small cell lung cancer is a highly aggressive subtype of lung cancer， and most patients are diagnosed with extensive- stage small cell lung cancer （ES-SCLC）. Conventional therapeutic regimens only achieve limited duration of remission； most patients experience recurrence or disease progression shortly after treatment， leading to poor long-term survival rates. Nevertheless， immunotherapy has revolutionized the treatment landscape of ES-SCLC. This paper reviews research advances in first-line immunotherapy combined with chemotherapy， maintenance therapy， and post-progression therapy for ES-SCLC. Programmed death receptor 1/programmed death-ligand 1 （PD-1/PD-L1） inhibitors combined with platinum plus etoposide serve as the cornerstone of first-line treatment for ES-SCLC. Regimens combining PD-1/PD-L1 inhibitors with anti-angiogenic agents， or dual immune checkpoint inhibitors plus platinum-etoposide chemotherapy， exhibit promising prospects， yet their additional survival benefits remain unconfirmed. In maintenance therapy， lurbinectedin combined with atezolizumab has yielded positive results in phase Ⅲ clinical trials， whereas maintenance regimens such as tarlatamab combined with PD-L1 inhibitors require further validation. For patients with disease progression after first-line immunochemotherapy， tarlatamab， a T-cell engager targeting delta-like ligand 3/ cluster of differentiation 3， has demonstrated survival benefits， and antibody-drug conjugates targeting B7 homolog 3 and trophoblast cell-surface antigen 2 also exert moderate anti-tumor activity. In the future， further investigations are required to identify the optimal combination regimens， treatment sequences and beneficiary populations for immunotherapy in ES-SCLC. |
| 期刊： | 2026年第37卷第15期 |
| 作者： | 王新月；康凯 |
| AUTHORS： | WANG Xinyue，KANG Kai |
| 关键字： | 广泛期小细胞肺癌；免疫治疗；免疫检查点抑制剂；维持治疗；抗体偶联药物 |
| KEYWORDS： | extensive-stage small cell lung cancer； immunotherapy； immune checkpoint inhibitor； maintenance therapy； |
| 阅读数： | 1 次 |
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