Non-Small-Cell Lung Cancer: Role of the Immune System and Potential for Immunotherapy.
Non-Small-Cell Lung Cancer: Role of the Immune System and Potential for Immunotherapy.
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DOI：
10.1097/jto.0000000000000551
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发表时间：
2015-07
期刊：
影响因子：
--
通讯作者：
Paz-Ares L
中科院分区：
文献类型：
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作者：
Carbone DP;Gandara DR;Antonia SJ;Zielinski C;Paz-Ares L
作为全球癌症死亡的主要原因，肺癌继续给医疗保健系统带来重大负担，并给临床医生和患者带来重大挑战。大多数患者在诊断时患有晚期疾病，预后不良，绝大多数存活不到5年。尽管近年来已经引入了靶向存在于患者亚组中的分子疾病驱动因素的新疗法，但仍然非常需要能够改善反应并延长生存期，同时最大限度地减少对生活质量的影响的治疗。肺癌免疫治疗方法的临床疗效的最新证据表明，它们将成为这种疾病的下一个主要治疗进展。非小细胞肺癌（NSCLC）约占肺癌病例的85%，历史上被认为是一种非免疫原性疾病;然而，与其他几种恶性肿瘤一样，最近的数据显示，这种免疫反应性缺乏大部分是功能性的，而不是结构性的（即，可以通过治疗克服）。这篇综述探讨了免疫系统参与NSCLC的关键因素，并简要探讨了免疫调节策略的发展，以转移免疫活性的平衡远离肿瘤诱导的免疫抑制状态，向积极的抗肿瘤免疫反应。
As the leading cause of cancer death worldwide, lung cancer continues to impose a major burden on healthcare systems and cause significant challenges for clinicians and patients. Most patients present with advanced disease at the time of diagnosis and have a poor prognosis, with the vast majority surviving less than 5 years. Although new therapies have been introduced in recent years that target molecular disease drivers present in a subset of patients, there is a significant need for treatments able to improve response and extend survival while minimizing effects on quality of life. Recent evidence of clinical efficacy for immunotherapeutic approaches for lung cancer suggests that they will become the next major therapeutic advance for this disease. Non–small cell lung cancer (NSCLC), which accounts for around 85% of lung cancer cases, has historically been considered a nonimmunogenic disease; however, as with several other malignancies, recent data show that much of this lack of immune responsiveness is functional rather than structural (ie, possible to overcome therapeutically). This review explores the key elements of the immune system involved in NSCLC and briefly examines immunotherapeutic strategies in development to shift the balance of immune activity away from a tumor-induced immune-suppressive state toward an active antitumor immune response.