Second-line therapy of squamous non-small cell lung cancer: an evolving landscape
Second-line therapy of squamous non-small cell lung cancer: an evolving landscape
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DOI：
10.1080/17476348.2017.1326822
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发表时间：
2017-01-01
影响因子：
3.9
通讯作者：
Santarpia, Mariacarmela
中科院分区：
文献类型：
--
作者：
Lazzari, Chiara;Karachaliou, Niki;Santarpia, Mariacarmela
在过去的几年里，肺癌的治疗已经发生了根本性的变化。可药物致癌改变的发现和免疫疗法的引入为肺癌患者提供了比化疗更有效、毒性更小的治疗选择的可能性。在肺鳞状细胞癌（LSCC）的病例中，治疗进展比腺癌慢，已经有几种靶向药物被批准用于腺癌。在世界上大多数地区，LSCC的标准一线治疗是铂类化疗。在疾病进展后，这些患者现在有新的治疗选择，包括抗血管生成药物和免疫检查点阻断。涵盖领域：我们总结了最近LSCC二线治疗的新进展，重点介绍了已获得监管部门批准的最重要临床试验的结果。专家评论：免疫检查点抑制剂已经改变了LSCC患者的治疗算法。其他二线治疗方案包括ramucirumab联合多西他赛和阿法替尼。然而，我们仍然缺乏生物标志物来预测哪些患者对每种治疗有更好的反应。尽管已经确定了几种可行的分子改变，但目前还没有批准的针对晚期LSCC的靶向药物。正在进行的生物标志物驱动研究的结果迫切需要为分子选择的亚组患者建立有效的治疗方法。
Introduction: The treatment of lung cancer has radically changed over the last few years. The discovery of druggable oncogenic alterations and the introduction of immunotherapy have provided lung cancer patients with the possibility of more efficient and less toxic therapeutic alternatives than chemotherapy. In the case of lung squamous cell carcinoma (LSCC), the treatment progress is slower than adenocarcinoma, for which several targeted agents have been already approved. The standard first-line therapy for LSCC, in most sites of the world, is platinum-based chemotherapy. After disease progression, these patients now have novel treatment options, including antiangiogenic agents and immune checkpoint blockade.Areas covered: We provide a summary of the recent novelties for the second-line therapy of LSCC, emphasizing on the results of the most important clinical trials that have led to regulatory approvals.Expert commentary: Immune checkpoint inhibitors have changed the therapeutic algorithm for LSCC patients. Other treatment options in the second-line setting include ramucirumab in combination with docetaxel and afatinib. However, we still lack biomarkers to predict which patients could respond better to each treatment. Despite the identification of several actionable molecular alterations, there are no approved targeted agents specific for advanced LSCC. Results from ongoing biomarker-driven studies are eagerly awaited to establish effective treatments for molecularly selected subgroups of patients.