Neoadjuvant therapy in non-small cell lung cancer: basis, promise, and challenges.
Neoadjuvant therapy in non-small cell lung cancer: basis, promise, and challenges.
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非小细胞肺癌的新辅助治疗：基础、前景和挑战。
DOI：
10.3389/fonc.2023.1286104
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发表时间：
2023
影响因子：
4.7
通讯作者：
Barbi, Joseph
中科院分区：
文献类型：
--
作者：
Kalvapudi, Sukumar;Vedire, Yeshwanth;Yendamuri, Sai;Barbi, Joseph
早期非小细胞肺癌（NSCLC）的生存率仍然很低，尽管手术切除和全身辅助治疗的标准已经建立了十年之久。认识到这一点，研究人员正在探索新的治疗靶点，并部署新辅助治疗来预测和改善肺癌患者的临床和病理结局。新辅助治疗也越来越多地被用于疾病的前期分期，以允许具有治愈目的的切除。在这篇综述中，我们的目的是总结当前和发展景观使用新辅助治疗在非小细胞肺癌的管理。于2023年1月15日检索了PubMed.gov和ClinicalTrials.gov数据库，以识别与本综述相关的已发表研究和试验。选择了107篇已发表的文章和17项正在进行的临床试验，并对相关结果和信息进行了审查。通过临床试验和荟萃分析证明，新辅助治疗的安全性和有效性与辅助治疗相当，有时甚至超过辅助治疗。通过早期攻击微转移和减少肿瘤负荷，它可以有效降低疾病的分期，允许治愈性手术切除尝试。对新辅助治疗的研究需要开发替代终点，如主要病理学缓解（MPR）和病理学完全缓解（pCR），以缩短临床试验的持续时间。新型化疗、免疫治疗和靶向治疗药物正在以极快的速度进行测试，为NSCLC的个性化全身治疗的未来铺平了道路。然而，挑战仍然存在，阻止进一步主流采用术前（新辅助）治疗。这些包括在不良事件或治疗抵抗的情况下延迟治愈性手术切除的风险。此外，疾病治愈的替代标志物的预测价值仍然需要强有力的验证。最后，与辅助治疗相比，已发表的数据仍然有限。需要通过更多大规模随机对照试验来解决这些问题。
Survival rates for early-stage non-small cell lung cancer (NSCLC) remain poor despite the decade-long established standard of surgical resection and systemic adjuvant therapy. Realizing this, researchers are exploring novel therapeutic targets and deploying neoadjuvant therapies to predict and improve clinical and pathological outcomes in lung cancer patients. Neoadjuvant therapy is also increasingly being used to downstage disease to allow for resection with a curative intent. In this review, we aim to summarize the current and developing landscape of using neoadjuvant therapy in the management of NSCLC. The PubMed.gov and the ClinicalTrials.gov databases were searched on 15 January 2023, to identify published research studies and trials relevant to this review. One hundred and seven published articles and seventeen ongoing clinical trials were selected, and relevant findings and information was reviewed. Neoadjuvant therapy, proven through clinical trials and meta-analyses, exhibits safety and efficacy comparable to or sometimes surpassing adjuvant therapy. By attacking micro-metastases early and reducing tumor burden, it allows for effective downstaging of disease, allowing for curative surgical resection attempts. Research into neoadjuvant therapy has necessitated the development of surrogate endpoints such as major pathologic response (MPR) and pathologic complete response (pCR) allowing for shorter duration clinical trials. Novel chemotherapy, immunotherapy, and targeted therapy agents are being tested at a furious rate, paving the way for a future of personalized systemic therapy in NSCLC. However, challenges remain that prevent further mainstream adoption of preoperative (Neoadjuvant) therapy. These include the risk of delaying curative surgical resection in scenarios of adverse events or treatment resistance. Also, the predictive value of surrogate markers of disease cure still needs robust verification. Finally, the body of published data is still limited compared to adjuvant therapy. Addressing these concerns with more large scale randomized controlled trials is needed.
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DOI：
10.3390/curroncol28050350
发表时间：
2021-10-13
期刊：
Current oncology (Toronto, Ont.)
影响因子：
--
作者：
Chen X;Ma K
通讯作者：
Ma K
DOI：
10.1200/jco.20.01605
发表时间：
2021-03-01
期刊：
Journal of clinical oncology : official journal of the American Society of Clinical Oncology
影响因子：
--
作者：
Borghaei H;Gettinger S;Vokes EE;Chow LQM;Burgio MA;de Castro Carpeno J;Pluzanski A;Arrieta O;Frontera OA;Chiari R;Butts C;Wójcik-Tomaszewska J;Coudert B;Garassino MC;Ready N;Felip E;García MA;Waterhouse D;Domine M;Barlesi F;Antonia S;Wohlleber M;Gerber DE;Czyzewicz G;Spigel DR;Crino L;Eberhardt WEE;Li A;Marimuthu S;Brahmer J
通讯作者：
Brahmer J
影响因子：
82.9
作者：
Chaft, Jamie E.;Oezkan, Filiz;Kris, Mark G.;Bunn, Paul A.;Wistuba, Ignacio I.;Kwiatkowski, David J.;Owen, Dwight H.;Tang, Yan;Johnson, Bruce E.;Lee, Jay M.;Lozanski, Gerard;Pietrzak, Maciej;Seweryn, Michal;Byun, Woo Yul;Schulze, Katja;Nicholas, Alan;Johnson, Ann;Grindheim, Jessica;Hilz, Stephanie;Shames, David S.;Rivard, Chris;Toloza, Eric;Haura, Eric B.;McNamee, Ciaran J.;Patterson, G. Alexander;Waqar, Saiama N.;Rusch, Valerie W.;Carbone, David P.
通讯作者：
Carbone, David P.
影响因子：
11.2
作者：
Brooks, Jennifer;Fleischmann-Mundt, Bettina;Kuehnel, Florian
通讯作者：
Kuehnel, Florian
影响因子：
1.5
作者：
An, Ming-Wen;Tang, Jun;Mandrekar, Sumithra J.
通讯作者：
Mandrekar, Sumithra J.