Mechanistic insights into the immune biomarker of perioperative immune checkpoint inhibitors for non-small cell lung cancer.

IF 3.5 2区 医学 Q2 ONCOLOGY
Translational lung cancer research Pub Date : 2025-07-31 Epub Date: 2025-07-16 DOI:10.21037/tlcr-2025-162
Yanting Long, Runsen Jin, Hecheng Li
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引用次数: 0

Abstract

Immune checkpoint inhibitors (ICIs) targeting the programmed cell death protein 1/programmed death-ligand 1 (PD-1/PD-L1) axis have revolutionized the treatment of non-small cell lung cancer (NSCLC), demonstrating remarkable efficacy in advanced-stage patients. These therapies have demonstrated durable responses and improved survival outcomes. Recently, perioperative ICIs have emerged as a promising approach for early-stage resectable NSCLC to address high postoperative recurrence rates and improve long-term survival. Clinical trials on adjuvant, neoadjuvant, and a combination of both perioperative ICIs therapies, such as CheckMate 816 and KEYNOTE-671, have demonstrated improvements in pathological complete response (pCR), event-free survival (EFS), and overall survival (OS). However, challenges remain, including low response rates in NSCLC patients and the occurrence of immune-related adverse events (irAEs). These factors highlight the urgent need for robust predictive biomarkers to better stratify patients and guide clinical decision-making. While numerous studies have explored the predictive and guiding value of various biomarkers, few have reached clinical application, leaving significant gaps. Moreover, the complexity and heterogeneity of tumor-immune interactions underscore the need for integrated, multimodal predictive models. This review highlights the current state and unresolved challenges in perioperative ICIs treatment for early-stage resectable NSCLC, emphasizing the critical role of biomarkers in advancing these therapies. It provides a comprehensive summary of potential biomarkers identified in recent research, elucidating their predictive mechanisms and interrelationships. The goal is to inspire the discovery of novel biomarkers and support the integration of multiple biomarkers for combined predictive models, ultimately optimizing patient selection and therapeutic outcomes.

非小细胞肺癌围手术期免疫检查点抑制剂免疫生物标志物的机制研究
靶向程序性细胞死亡蛋白1/程序性死亡配体1 (PD-1/PD-L1)轴的免疫检查点抑制剂(ICIs)已经彻底改变了非小细胞肺癌(NSCLC)的治疗,在晚期患者中显示出显着的疗效。这些疗法显示出持久的疗效和改善的生存结果。最近,围手术期ICIs已成为早期可切除NSCLC的一种有希望的方法,以解决高术后复发率和提高长期生存率。辅助、新辅助和两种围手术期ICIs治疗的联合临床试验,如CheckMate 816和KEYNOTE-671,已经证明了病理完全缓解(pCR)、无事件生存(EFS)和总生存(OS)的改善。然而,挑战仍然存在,包括NSCLC患者的低应答率和免疫相关不良事件(irAEs)的发生。这些因素突出了迫切需要强大的预测性生物标志物来更好地对患者进行分层和指导临床决策。虽然有许多研究探索了各种生物标志物的预测和指导价值,但很少有研究进入临床应用,留下了很大的空白。此外,肿瘤免疫相互作用的复杂性和异质性强调了对综合、多模态预测模型的需求。本综述强调了早期可切除NSCLC围手术期ICIs治疗的现状和未解决的挑战,强调了生物标志物在推进这些治疗中的关键作用。它提供了最近研究中发现的潜在生物标志物的综合总结,阐明了它们的预测机制和相互关系。目标是激发新的生物标志物的发现,并支持多种生物标志物的组合预测模型,最终优化患者选择和治疗结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.20
自引率
2.50%
发文量
137
期刊介绍: Translational Lung Cancer Research(TLCR, Transl Lung Cancer Res, Print ISSN 2218-6751; Online ISSN 2226-4477) is an international, peer-reviewed, open-access journal, which was founded in March 2012. TLCR is indexed by PubMed/PubMed Central and the Chemical Abstracts Service (CAS) Databases. It is published quarterly the first year, and published bimonthly since February 2013. It provides practical up-to-date information on prevention, early detection, diagnosis, and treatment of lung cancer. Specific areas of its interest include, but not limited to, multimodality therapy, markers, imaging, tumor biology, pathology, chemoprevention, and technical advances related to lung cancer.
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