Adjuvant intensification strategies for non-small cell lung cancer patients with non-pathological complete response after neoadjuvant immunotherapy combined with chemotherapy
DOI:10.3872/j.issn.1007-385X.2026.07.001
- VernacularTitle:新辅助免疫联合化疗后非病理完全缓解的非小细胞肺癌患者的辅助强化治疗策略
- Author:
Jiang Zhanshenga
1
;
Xu Jieb△
1
;
Zhang Zhenfab
1
;
Pan Zhanyua
1
Author Information
1. a. Department of Integrated Chinese and Western Medicine; b. Department of Lung Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin City, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Immunology and Biotherapy [Tianjin], Tianjin 300060, China
- Publication Type:Journal Article
- Keywords:
非小细胞肺癌;新辅助免疫联合化疗;非病理完全缓解;辅助强化治疗
- From:
Chinese Journal of Cancer Biotherapy
2026;33(7):709-718
- CountryChina
- Language:Chinese
-
Abstract:
新辅助免疫联合化疗(NICT)已成为可切除的非小细胞肺癌(NSCLC)的标准治疗模式,但约80%的患者术后仍存在残留病灶(非病理完全缓解,non-pCR)。这部分患者的长期生存显著低于达到病理完全缓解(pCR)的患者,5年总生存(OS)率约55%,成为当前围手术期治疗的重大挑战。借鉴乳腺癌领域对non-pCR患者实施辅助强化治疗(如恩美曲妥珠单抗、卡培他滨)的经验,本文探讨NSCLC在NICT后non-pCR人群的辅助治疗策略优化路径。重点分析了多种具有潜力的辅助强化手段,包括抗血管生成药物、抗体药物偶联物(ADC)、双特异性抗体(BsAb)、个体化新抗原疫苗及放疗和口服化疗药物等,旨在为清除耐药残留克隆提供新策略。同时提出可根据残留存活肿瘤(RVT)比例对复发风险进行精细分层、基于分子残留病灶(MRD)进行动态监测,建立整合RVT与MRD状态的风险自适应模型,以实现“因人施策”的个体化辅助强化治疗,以期改善non-pCR NSCLC人群的生存预后,并为该领域提供理论依据与研究方向。
- Full text:202608190845134483620260701.pdf