可切除非小细胞肺癌新辅助免疫化疗的非侵入性生物标志物研究进展

Research progress of non-invasive biomarkers for neoadjuvant immunotherapycombined with chemotherapy in resectable non-small cell lung cancer

  • 摘要: 随着免疫检查点抑制剂在诸多非小细胞肺癌(non-small cell lung cancer, NSCLC)队列中取得较好疗效,新辅助免疫联合化疗已经成为Ⅱ~ⅢB期可切除NSCLC降低手术风险、改善病理缓解和术后生存预后的重要临床治疗手段。新辅助免疫治疗疗效及患者生存预后存在个体化差异,鉴于依赖肿瘤组织病理检测的程序性死亡配体1(programmed cell death-ligand 1,PD-L1)表达及肿瘤突变负荷(tumor mutation burden,TMB)在预测新辅助免疫治疗疗效及动态监测疗效存在局限性,基于外周血及影像的非侵入性生物标志物的研究得到广泛关注。本文就来源于外周血的炎性衍生物、T淋巴细胞亚群、细胞因子和基于CT图像的影像组学特征对NSCLC患者新辅助免疫联合化疗疗效及生存预后预测价值的研究进展进行综述。

     

    Abstract: With the promising overall efficacy of immune checkpoint inhibitors in non-small cell lung cancer (NSCLC) cohorts, neoadjuvant immunochemotherapy (NAIC) has emerged as a crucial clinical treatment for reducing surgical risks, improving pathological responses, and enhancing postoperative survival prognosis for patients with stage Ⅱ-ⅢB resectable NSCLC. However, the efficacy of NAIC and patient survival outcomes vary between studies. Given the limitations of tissue-based programmed cell death-ligand 1 (PD-L1) expression and tumor mutation burden (TMB) in dynamically monitoring the therapeutic efficacy of NAIC, alternative non-invasive potential biomarkers based on peripheral blood and imaging have gained widespread attention. This review highlights the advances in potential biomarkers, including inflammatory derivatives, T-lymphocyte subsets, cytokines from peripheral blood, and radiomic features derived from CT images, for predicting the therapeutic efficacy and survival outcomes of NAIC in patients with NSCLC.

     

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