免疫检查点PD-1/PD-L1通路在小细胞肺癌中的作用

摘要

小细胞肺癌(SCLC)主要的特点为生长迅速且早期易发生广泛转移.尽管SCLC对于化疗和放疗敏感,但几乎所有的患者均在治疗后发生复发转移,预后差.免疫检测点抑制剂,尤其程序化细胞死亡受体-1(PD-1)/程序化细胞死亡配体-1(PD-L1)拮抗剂在SCLC的临床前和临床研究中均获得了良好效果,并且能够延长患者生存.免疫检测点疗法作为一种新兴的方法在未来可能会改变SCLC治疗模式.此外,有限的数据显示出PD-L1表达可能成为筛选获益人群一个有效的生物标记物.本文总结PD-L1作为标记物的发展历程,并同时阐述PD-1/PD-L1抑制剂在SCLC治疗中的进展.%Small-cell lung cancer(SCLC)is characterized by its rapid growth and early development of widespread metastases.Although patients with SCLC are highly responsive to chemotherapy and radiation therapy,long-term prognosis remains poor,with relapse and disease metastasis occurring in almost all cases.Immune checkpoint blockade,especially blockade of programmed death-1(PD-1)receptor and its ligand PD-L1,achieved robust responses and improved survival for patients with SCLC in preclinical and clinical studies.The blockade of PD-1/PD-L1 pathway as a novel therapeutic approach may change the treatment paradigm of SCLC in the future.Data on clinical activity by programmed cell death-1 ligand expression in SCLC are not widely available.In addition,limited data indicate that PD-L1 expression may be an ideal biomarker for patient selection.Here,we summarize the brief history of PD-L1 as a biomarker and describe the critical role of PD-1/PD-L1 inhibitors in SCLC.