The frontier of neoadjuvant therapy in non-small cell lung cancer beyond PD-(L)1 agents.

IF 3.6 3区医学 Q2 BIOTECHNOLOGY & APPLIED MICROBIOLOGY Expert Opinion on Biological Therapy Pub Date : 2024-10-01 Epub Date: 2024-09-25 DOI:10.1080/14712598.2024.2408292

Marco Sposito, Serena Eccher, Ilaria Scaglione, Alice Avancini, Antonio Rossi, Sara Pilotto, Lorenzo Belluomini

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Abstract

Introduction: While surgical resection is the cornerstone of treatment for resectable lung cancer, neoadjuvant/adjuvant chemotherapy has shown limited improvement in survival rates over the past decades. With the success of immune checkpoint inhibitors (ICIs) in advanced NSCLC, there is growing interest in their application in earlier stages of the disease. Recent approvals for neoadjuvant/adjuvant ICIs in stage II-IIIA NSCLC highlight this shift in treatment paradigms.

Areas covered: In this review, we aim to explore available data regarding alternative agents beyond the PD-(L)1 inhibitors, such as monoclonal antibodies against CTLA4, LAG3, TIGIT, antiangiogenic drugs, and novel therapies (antibody drug conjugates, bispecific antibodies) in neoadjuvant/perioperative regimens.

Expert opinion: Novel agents and combinations (with or without ICI or/and chemotherapy), guided by molecular profiling and immune phenotyping, showed promise in improving surgical and survival outcomes. Crucial is, also in early setting, to identifying biomarkers predictive of treatment efficacy in order to personalize neoadjuvant/perioperative treatment strategies.

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超越 PD-(L)1 药物的非小细胞肺癌新辅助疗法前沿。

导言：虽然手术切除是治疗可切除肺癌的基石，但过去几十年来，新辅助/辅助化疗对生存率的改善有限。随着免疫检查点抑制剂（ICIs）在晚期 NSCLC 中取得成功，人们对其在疾病早期阶段的应用越来越感兴趣。最近，新辅助/辅助 ICIs 在 II-IIIA 期 NSCLC 中的应用获得批准，凸显了治疗模式的转变：在这篇综述中，我们旨在探讨有关 PD-(L)1 抑制剂之外的替代药物的现有数据，如 CTLA4、LAG3、TIGIT 单克隆抗体、抗血管生成药物以及新辅助/围手术期治疗方案中的新型疗法（抗体药物共轭物、双特异性抗体）：专家观点：在分子谱分析和免疫表型分析的指导下，新型药物和组合（使用或不使用 ICI 或/和化疗）有望改善手术和生存效果。在早期治疗中，确定预测疗效的生物标志物以个性化新辅助治疗/围手术期治疗策略也至关重要。

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

Expert Opinion on Biological Therapy 医学-生物工程与应用微生物

CiteScore

8.60

自引率

0.00%

发文量

审稿时长

3-8 weeks

期刊介绍： Expert Opinion on Biological Therapy (1471-2598; 1744-7682) is a MEDLINE-indexed, international journal publishing peer-reviewed research across all aspects of biological therapy. Each article is structured to incorporate the author’s own expert opinion on the impact of the topic on research and clinical practice and the scope for future development. The audience consists of scientists and managers in the healthcare and biopharmaceutical industries and others closely involved in the development and application of biological therapies for the treatment of human disease. The journal welcomes: Reviews covering therapeutic antibodies and vaccines, peptides and proteins, gene therapies and gene transfer technologies, cell-based therapies and regenerative medicine Drug evaluations reviewing the clinical data on a particular biological agent Original research papers reporting the results of clinical investigations on biological agents and biotherapeutic-based studies with a strong link to clinical practice Comprehensive coverage in each review is complemented by the unique Expert Collection format and includes the following sections: Expert Opinion – a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results; Article Highlights – an executive summary of the author’s most critical points.