Revue des Maladies Respiratoires Actualites最新文献

英文中文

Néoplasies neuroendocrines pulmonaires hors cancers du poumon à petites cellules : tumeurs carcinoïdes et carcinomes neuroendocrines à grandes cellules 非小细胞肺癌的肺神经内分泌肿瘤：类癌和大细胞神经内分泌癌

Q4 Medicine

Revue des Maladies Respiratoires Actualites

Pub Date : 2025-10-01 DOI: 10.1016/S1877-1203(25)00083-7

L. Odier , M. Darrason , M. Duruisseaux , T. Walter , L. Gérinière , A. Durand , D. Arpin

Primary pulmonary neuroendocrine neoplasms comprise several distinct entities, corresponding to four main histological subtypes: well-differentiated neuroendocrine tumors, including typical low-grade carcinoids and atypical intermediate grade carcinoids; and small-cell and large-cell neuroendocrine carcinomas of high grade.

There are specific recommendations for the pre-treatment assessment of carcinoid tumors. Clinical suspicion of a secretory syndrome must be confirmed by appropriate biological tests. In the case of metastatic carcinoid tumors, management begins with controlling any carcinoid secretory syndrome using somatostatin analogues. Oncological treatment is based on an assessment of tumor progression, with the possibility of simple monitoring, local treatment of metastases or even the primary tumor, treatment with somatostatin analogues, everolimus, cabozantinib, or, in cases of tumor aggressiveness, chemotherapy, preferably with the combination of oxaliplatin and gemcitabine. Internal radiotherapy vectorized by 177Lu-Dotatate may be offered on a compassionate use basis. In cases of metastatic large cell neuroendocrine carcinoma, the platinum-etoposide combination is typically used as first-line treatment. However, if RB1 expression is preserved or KRAS/STK11 mutations are present, a platinum-gemcitabine or platinumtaxane combination may be proposed.

There is no standard second-line treatment, and the therapies typically used in nonsmall cell lung cancer may be proposed, with the exception of pemetrexed.

原发性肺神经内分泌肿瘤包括几种不同的实体，对应于四种主要的组织学亚型：分化良好的神经内分泌肿瘤，包括典型的低级别类癌和非典型的中级类癌；高分级的小细胞和大细胞神经内分泌癌。对于类癌肿瘤的治疗前评估有具体的建议。临床怀疑有分泌综合征必须通过适当的生物学试验加以证实。在转移性类癌肿瘤的情况下，管理始于使用生长抑素类似物控制任何类癌分泌综合征。肿瘤治疗基于对肿瘤进展的评估，可能进行简单监测，局部治疗转移甚至原发肿瘤，使用生长抑素类似物，依维莫司，卡博赞替尼治疗，或者在肿瘤侵袭性的情况下，化疗，最好是奥沙利铂和吉西他滨联合治疗。由177Lu-Dotatate矢量化的内部放疗可以在同情使用的基础上提供。在转移性大细胞神经内分泌癌的病例中，铂-依托泊苷联合治疗通常用作一线治疗。然而，如果RB1表达保留或KRAS/STK11突变存在，可能会提出铂-吉西他滨或铂紫杉烷联合用药。目前还没有标准的二线治疗，除了培美曲塞外，非小细胞肺癌通常使用的治疗方法可能会被提出。

{"title":"Néoplasies neuroendocrines pulmonaires hors cancers du poumon à petites cellules : tumeurs carcinoïdes et carcinomes neuroendocrines à grandes cellules","authors":"L. Odier , M. Darrason , M. Duruisseaux , T. Walter , L. Gérinière , A. Durand , D. Arpin","doi":"10.1016/S1877-1203(25)00083-7","DOIUrl":"10.1016/S1877-1203(25)00083-7","url":null,"abstract":"<div><div>Primary pulmonary neuroendocrine neoplasms comprise several distinct entities, corresponding to four main histological subtypes: well-differentiated neuroendocrine tumors, including typical low-grade carcinoids and atypical intermediate grade carcinoids; and small-cell and large-cell neuroendocrine carcinomas of high grade.</div><div>There are specific recommendations for the pre-treatment assessment of carcinoid tumors. Clinical suspicion of a secretory syndrome must be confirmed by appropriate biological tests. In the case of metastatic carcinoid tumors, management begins with controlling any carcinoid secretory syndrome using somatostatin analogues. Oncological treatment is based on an assessment of tumor progression, with the possibility of simple monitoring, local treatment of metastases or even the primary tumor, treatment with somatostatin analogues, everolimus, cabozantinib, or, in cases of tumor aggressiveness, chemotherapy, preferably with the combination of oxaliplatin and gemcitabine. Internal radiotherapy vectorized by 177Lu-Dotatate may be offered on a compassionate use basis. In cases of metastatic large cell neuroendocrine carcinoma, the platinum-etoposide combination is typically used as first-line treatment. However, if RB1 expression is preserved or KRAS/STK11 mutations are present, a platinum-gemcitabine or platinumtaxane combination may be proposed.</div><div>There is no standard second-line treatment, and the therapies typically used in nonsmall cell lung cancer may be proposed, with the exception of pemetrexed.</div></div>","PeriodicalId":53645,"journal":{"name":"Revue des Maladies Respiratoires Actualites","volume":"17 2","pages":"Pages 2S261-2S269"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145236605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Les métastases cérébrales et les méningites carcinomateuses des cancers bronchiques 脑转移和支气管癌的致癌脑膜炎

Q4 Medicine

Revue des Maladies Respiratoires Actualites

Pub Date : 2025-10-01 DOI: 10.1016/S1877-1203(25)00087-4

C. Decroisette , E. Perrot , P. Tomasini

Brain metastases and leptomeningeal metastases are severe and frequent complications of lung cancer, particularly in patients with EGFR mutations or ALK rearrangements. BM affect up to 80% of patients with small-cell lung cancer and 50% of those with non-smallcell lung cancer Stereotactic radiotherapy is the current gold standard for BM management, while whole-brain radiotherapy remains indicated in cases of multiple or diffuse lesions. Next-generation tyrosine kinase inhibitors, such as osimertinib and lorlatinib, have shown significant intracranial efficacy. LM diagnosis relies on MRI and cerebrospinal fluid analysis, with notable advances through next-generation sequencing that identifies mutations and resistance mechanisms. Treatment of LM remains complex. Clinical trials remain scarce for this population, highlighting an urgent need for dedicated research. Optimal integration of local and systemic therapies remains a major challenge in managing BM and LM in BC.

脑转移和轻脑膜转移是肺癌的严重和常见的并发症，特别是在EGFR突变或ALK重排的患者中。脑转移影响高达80%的小细胞肺癌患者和50%的非小细胞肺癌患者立体定向放疗是目前脑转移治疗的金标准，而在多发或弥漫性病变的情况下，仍需要全脑放疗。新一代酪氨酸激酶抑制剂，如奥西替尼和氯拉替尼，已显示出显著的颅内疗效。LM诊断依赖于MRI和脑脊液分析，通过下一代测序识别突变和耐药机制取得了显著进展。LM的治疗仍然很复杂。针对这一人群的临床试验仍然很少，因此迫切需要进行专门的研究。局部和全身治疗的最佳整合仍然是不列颠哥伦比亚省管理BM和LM的主要挑战。

引用次数: 0

Anticorps conjugués dans le cancer broncho-pulmonaire non à petites cellules : où en sommes-nous ? 非小细胞肺癌的结合抗体：我们在哪里？

Q4 Medicine

Revue des Maladies Respiratoires Actualites

Pub Date : 2025-10-01 DOI: 10.1016/S1877-1203(25)00074-6

D. Bruyat , P. Tomasini

Antibody-drug conjugates (ADCs) are an emerging therapeutic class in non-small cell lung cancer (NSCLC). They combine a monoclonal antibody with a potent cytotoxic payload via a cleavable linker, enabling selective tumor targeting with potentially reduced systemic toxicity. This review summarizes the latest data on ADCs in NSCLC, distinguishing targeted approaches based on oncogenic drivers (HER2, c-MET) from those exploiting stable, non-oncogenic membrane antigens (HER3, CEACAM5, B7-H3), as well as antigen-agnostic developments (TROP2). Clinical outcomes vary depending on the target and payload, but support the therapeutic potential of ADCs in difficult-to-treat populations. Specific toxicities, especially interstitial lung disease, require careful monitoring. Future directions include combining ADCs with immunotherapy or tyrosine kinase inhibitors, and optimizing the choice of payloads. Despite their high specificity, ADCs remain sophisticated cytotoxic agents requiring precise pharmacological control. 1877-1203/© 2025 SPLF. Published by Elsevier Masson SAS. All rights reserved.

抗体-药物偶联物（adc）是一种新兴的非小细胞肺癌（NSCLC）治疗药物。他们通过可切割的连接体将单克隆抗体与有效的细胞毒性载荷结合起来，实现选择性肿瘤靶向，潜在地降低了全身毒性。本文总结了非小细胞肺癌adc的最新数据，区分了基于致癌驱动因素（HER2, c-MET）和利用稳定的非致癌膜抗原（HER3, CEACAM5, B7-H3）以及抗原不确定发展（TROP2）的靶向方法。临床结果因靶点和有效载荷而异，但支持adc在难以治疗人群中的治疗潜力。特定毒性，特别是间质性肺疾病，需要仔细监测。未来的发展方向包括将adc与免疫疗法或酪氨酸激酶抑制剂联合使用，并优化有效载荷的选择。尽管adc具有很高的特异性，但它们仍然是复杂的细胞毒性药物，需要精确的药理控制。1877-1203/©2025 splf。Elsevier Masson SAS出版。版权所有。

引用次数: 0

Le TNM du cancer broncho-pulmonaire : quel bilan radio-anatomique ? 支气管肺癌的NMD：什么放射解剖学检查？

Q4 Medicine

Revue des Maladies Respiratoires Actualites

Pub Date : 2025-10-01 DOI: 10.1016/S1877-1203(25)00061-8

G. Ferretti , L. Ruez-Lantuejoul , E. Reymond , A.-C. Toffart , A. Khalil , V. Gounant , S. Boussouar

Non-invasive medical imaging is essential for the management of healthy subjects for screening or patients, whether for the diagnostic assessment of suspected tumor, the extension assessment before making a therapeutic decision in the MDC, or the posttherapeutic evaluation follow-up. Interventional radiology is used to obtain material from image-guided biopsies of the tumor or metastasis, which is essential for the diagnosis of certainty of lung cancer. Currently, the radio-anatomical exploration of patients is essentially based on contrast enhanced computed tomography, sometimes on MRI. CT is completed by functional information of PET FDG scintigraphy. The first objective of this paper is to expose the different anatomical diagnostic methods at our disposal to homogenize practices and optimize patient care. The second objective is to present the modalities of the NSCLC extension assessment, addressing the indications for imaging examinations as well as their limitations. We will consider the place of imaging in the ninth edition of the TNM (TNM-9); developed by the IASLC and adopted by the AJCC and UICC, entered into force on 1 January 2025.

无论是对疑似肿瘤的诊断评估、MDC治疗决定前的延伸评估，还是治疗后的随访评估，非侵入性医学成像对于健康受试者的筛查或患者的管理都是必不可少的。介入放射学用于从肿瘤或转移的图像引导活检中获取材料，这对于肺癌的确定性诊断至关重要。目前，患者的放射解剖探查基本上是基于增强的计算机断层扫描，有时是MRI。CT是通过PET FDG显像的功能信息完成的。本文的第一个目的是暴露不同的解剖诊断方法在我们的处置均质化做法和优化患者护理。第二个目的是介绍NSCLC扩展评估的模式，解决影像学检查的适应症及其局限性。我们将考虑成像在TNM第九版（TNM-9）中的地位；由IASLC制定并由AJCC和UICC通过，于2025年1月1日生效。

{"title":"Le TNM du cancer broncho-pulmonaire : quel bilan radio-anatomique ?","authors":"G. Ferretti , L. Ruez-Lantuejoul , E. Reymond , A.-C. Toffart , A. Khalil , V. Gounant , S. Boussouar","doi":"10.1016/S1877-1203(25)00061-8","DOIUrl":"10.1016/S1877-1203(25)00061-8","url":null,"abstract":"<div><div>Non-invasive medical imaging is essential for the management of healthy subjects for screening or patients, whether for the diagnostic assessment of suspected tumor, the extension assessment before making a therapeutic decision in the MDC, or the posttherapeutic evaluation follow-up. Interventional radiology is used to obtain material from image-guided biopsies of the tumor or metastasis, which is essential for the diagnosis of certainty of lung cancer. Currently, the radio-anatomical exploration of patients is essentially based on contrast enhanced computed tomography, sometimes on MRI. CT is completed by functional information of PET FDG scintigraphy. The first objective of this paper is to expose the different anatomical diagnostic methods at our disposal to homogenize practices and optimize patient care. The second objective is to present the modalities of the NSCLC extension assessment, addressing the indications for imaging examinations as well as their limitations. We will consider the place of imaging in the ninth edition of the TNM (TNM-9); developed by the IASLC and adopted by the AJCC and UICC, entered into force on 1 January 2025.</div></div>","PeriodicalId":53645,"journal":{"name":"Revue des Maladies Respiratoires Actualites","volume":"17 2","pages":"Pages 2S60-2S67"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145236488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cancer bronchique à petites cellules de stade étendu : quoi de neuf ? 晚期小细胞肺癌：有什么新消息？

Q4 Medicine

Revue des Maladies Respiratoires Actualites

Pub Date : 2025-10-01 DOI: 10.1016/S1877-1203(25)00082-5

D. Moro-Sibilot , S. Ocak , C. Ardin , E. Berton , P. Fournel , A.-C. Toffart

This article describes recent advances in the therapeutic management of extensivestage small cell lung cancer, particularly the development of immune checkpoint inhibitors and new agents targeting DLL3. He also cites still debatable issues such as thoracic radiotherapy and prophylactic cerebral irradiation. Finally, therapeutic approaches targeting DNA damage repair abnormalities are discussed.

本文介绍了广泛浸润性小细胞肺癌治疗管理的最新进展，特别是免疫检查点抑制剂和靶向DLL3的新药物的发展。他还引用了一些仍有争议的问题，如胸部放疗和预防性脑照射。最后，讨论了针对DNA损伤修复异常的治疗方法。

引用次数: 0

La prise en charge du fumeur en pratique quotidienne 在日常生活中照顾吸烟者

Q4 Medicine

Revue des Maladies Respiratoires Actualites

Pub Date : 2025-10-01 DOI: 10.1016/S1877-1203(25)00054-0

A.-M. Ruppert , D. Glesener

Tobacco control is the most effective measure to reduce the epidemic of lung cancer. Smoking cessation is also important in the management of patients with lung cancer regardless stage. For localized cancers, smoking is associated with decreased survival by increasing the risk of recurrence and by risking a second cancer. In the perioperative period, smoking cessation can reduce infectious complications and length of hospital stay. At all stages of lung cancer, smoking cessation improves dyspnoea, appetite and reduces fatigue; smoking cessation is thus associated with improved quality of life. Tobacco causes a strong physical, psychological and behavioural dependence. In case of physical nicotine addiction, nicotine replacement therapy, varenicline and cystisine are indicated. The electronic cigarette should be considered as a smoking cessation tool. Cognitive behavioural therapy helps smokers overcome their smoking behaviour and plays an important role in relapse prevention.

控制烟草是减少肺癌流行的最有效措施。戒烟在肺癌患者的管理中也很重要，无论分期如何。对于局部癌症，吸烟会增加复发的风险和患第二次癌症的风险，从而降低生存率。在围手术期，戒烟可以减少感染并发症和住院时间。在肺癌的所有阶段，戒烟可以改善呼吸困难、食欲和减轻疲劳；因此，戒烟与提高生活质量有关。烟草造成强烈的身体、心理和行为依赖。对烟碱成瘾性的患者，建议使用尼古丁替代疗法、伐尼克兰和胱氨酸。电子烟应该被视为一种戒烟工具。认知行为疗法帮助吸烟者克服吸烟行为，并在预防复吸方面发挥重要作用。

引用次数: 0

Prise en charge systémique du cancer bronchique non à petites cellules chez les sujets âgés 老年人非小细胞肺癌的系统管理

Q4 Medicine

Revue des Maladies Respiratoires Actualites

Pub Date : 2025-10-01 DOI: 10.1016/S1877-1203(25)00090-4

L. Pabst , R. Corre , E. Quoix , C. Mascaux

Non-small-cell lung cancer (NSCLC) is mostly diagnosed in elderly persons. Its incidence is expected to increase in Western countries because of the ageing of the population and the increase of cancer frequency with age. The purpose of this article is to synthesize the published data available to manage elderly patients with NSCLC at various stages: earlystage, locally advanced inoperable and metastatic. We will discuss, in metastatic setting, the respective contributions of chemotherapies, targeted therapies and immunotherapies. International recommendations have been published but they are difficult to apply because of the lack of consensual definition of frailties relevant to make treatment decision and to adapt it. We also here discuss data about the use of comprehensive geriatric assessment.

非小细胞肺癌（NSCLC）多见于老年人。由于人口老龄化和癌症发病率随年龄增长而增加，预计其发病率将在西方国家增加。本文的目的是综合已发表的数据，以管理不同阶段的老年非小细胞肺癌患者：早期，局部晚期不能手术和转移。我们将讨论，在转移设置，化疗，靶向治疗和免疫治疗各自的贡献。国际上已经发表了一些建议，但由于缺乏与作出治疗决定和调整治疗决定有关的共识性弱点的定义，这些建议很难实施。我们也在这里讨论有关使用综合老年评估的数据。

引用次数: 0

Maladies thromboemboliques et cancer du poumon 血栓栓塞性疾病和肺癌

Q4 Medicine

Revue des Maladies Respiratoires Actualites

Pub Date : 2025-10-01 DOI: 10.1016/S1877-1203(25)00092-8

G. Poenou , C. Marie-Sainte , A.-L. Desage , C. Gravelier , S. Accassat , L. Bertoletti

Lung cancer is among the malignancies most strongly associated with thrombotic risk. This close association is often first revealed either by the diagnosis of pulmonary embolism in a patient with lung cancer or, conversely, by the detection of cancer following a thromboembolic event. The underlying pathophysiology involves multiple risk factors, including cancer-specific mechanisms, treatment-related effects, patient characteristics, and genetic biomarkers. Thrombosis in the context of lung cancer carries significant prognostic implications and must be carefullyconsidered. Pulmonaryembolism, in particular, maybe diagnosed incidentally but should never be underestimated in terms of clinical significance. Specific clinical situations—such as perioperative periods or during certain oncologic treatments—require a rigorous, individualized evaluation of the risk-benefit balance regarding the initiation of thromboprophylaxis. This need for personalized risk assessment comes from the delicate equilibrium between thrombosis and bleeding in patients with lung cancer. In patients who have already experienced a thrombotic event, the use of direct oral anticoagulants is a valid therapeutic option, provided that thrombotic and hemorrhagic risks, contraindications, and potential drug-drug interactions are carefully evaluated.

肺癌是与血栓形成风险最密切相关的恶性肿瘤之一。这种密切关联通常首先通过肺癌患者的肺栓塞诊断或相反，通过血栓栓塞事件后的癌症检测来揭示。潜在的病理生理学涉及多种危险因素，包括癌症特异性机制、治疗相关效应、患者特征和遗传生物标志物。在肺癌的背景下，血栓形成具有重要的预后意义，必须仔细考虑。特别是肺栓塞，可能是偶然诊断的，但绝不应低估其临床意义。特定的临床情况，如围手术期或某些肿瘤治疗期间，需要对开始血栓预防的风险-收益平衡进行严格、个性化的评估。这种个性化风险评估的需求来自于肺癌患者血栓和出血之间的微妙平衡。对于已经发生血栓事件的患者，只要仔细评估血栓和出血风险、禁忌症和潜在的药物-药物相互作用，直接使用口服抗凝剂是一种有效的治疗选择。

{"title":"Maladies thromboemboliques et cancer du poumon","authors":"G. Poenou , C. Marie-Sainte , A.-L. Desage , C. Gravelier , S. Accassat , L. Bertoletti","doi":"10.1016/S1877-1203(25)00092-8","DOIUrl":"10.1016/S1877-1203(25)00092-8","url":null,"abstract":"<div><div>Lung cancer is among the malignancies most strongly associated with thrombotic risk. This close association is often first revealed either by the diagnosis of pulmonary embolism in a patient with lung cancer or, conversely, by the detection of cancer following a thromboembolic event. The underlying pathophysiology involves multiple risk factors, including cancer-specific mechanisms, treatment-related effects, patient characteristics, and genetic biomarkers. Thrombosis in the context of lung cancer carries significant prognostic implications and must be carefullyconsidered. Pulmonaryembolism, in particular, maybe diagnosed incidentally but should never be underestimated in terms of clinical significance. Specific clinical situations—such as perioperative periods or during certain oncologic treatments—require a rigorous, individualized evaluation of the risk-benefit balance regarding the initiation of thromboprophylaxis. This need for personalized risk assessment comes from the delicate equilibrium between thrombosis and bleeding in patients with lung cancer. In patients who have already experienced a thrombotic event, the use of direct oral anticoagulants is a valid therapeutic option, provided that thrombotic and hemorrhagic risks, contraindications, and potential drug-drug interactions are carefully evaluated.</div></div>","PeriodicalId":53645,"journal":{"name":"Revue des Maladies Respiratoires Actualites","volume":"17 2","pages":"Pages 2S341-2S349"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145236613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Algorithme thérapeutique des CBNPC sans anomalie moléculaire actionnable en première ligne de traitement 一线治疗无可操作分子异常的CBNPC治疗算法

Q4 Medicine

Revue des Maladies Respiratoires Actualites

Pub Date : 2025-10-01 DOI: 10.1016/S1877-1203(25)00072-2

A.-C. Toffart , J. Mazières , M. Pérol , E. Berton , A. Cortot , D. Moro-Sibilot

The development of immunotherapy in first-line therapy with anti-PD-1 and anti-PD-L1 has changed the first line treatment algorithm of advanced non-small cell lung cancer (NSCLC). The anti-PD-(L)1 atézolizumab, cemiplimaband pembrolizumab clearly improve the overall survival in NSCLC with high PD-L1 expression (> 50% of tumour cells), comparatively to cytotoxic chemotherapy. Combinations of anti-PD(L)-1 to platinum-based chemotherapy are superior to chemotherapy alone, regardless of PD-L1 level of expression. They represent the 1st line gold-standard when PD-L1 is expressed in less than 50% of tumour cells and might reduce the risk of early disease progression in comparison with pembrolizumab when PD-L1 > 50%. The room for anti-CTLA-4 + anti-PD(L)-1 combinations which are not available in France remains to be established. Immunotherapy still benefits only a minority of patients whose identification is imperfect, underscoring the need for new strategies based on new combinations amplifying the anti-tumour immune response as well as understanding the mechanisms of resistance to treatment in order to improve these results.

免疫疗法在一线抗pd -1和抗pd - l1治疗中的发展改变了晚期非小细胞肺癌（NSCLC）一线治疗的算法。与细胞毒性化疗相比，抗pd -(L)1 atsamzolizumab、cemiplimaband pembrolizumab明显提高了PD-L1高表达（50%肿瘤细胞）的NSCLC的总生存率。无论PD-L1表达水平如何，抗pd (L)-1联合铂基化疗优于单独化疗。当PD-L1在不到50%的肿瘤细胞中表达时，它们代表一线金标准，与派姆单抗相比，当PD-L1在50%时，它们可能降低早期疾病进展的风险。抗ctla -4 +抗pd (L)-1组合的空间仍有待建立，这在法国是不可用的。免疫治疗仍然只使少数身份不完善的患者受益，强调需要基于新组合的新策略，增强抗肿瘤免疫反应，并了解对治疗的耐药性机制，以改善这些结果。

{"title":"Algorithme thérapeutique des CBNPC sans anomalie moléculaire actionnable en première ligne de traitement","authors":"A.-C. Toffart , J. Mazières , M. Pérol , E. Berton , A. Cortot , D. Moro-Sibilot","doi":"10.1016/S1877-1203(25)00072-2","DOIUrl":"10.1016/S1877-1203(25)00072-2","url":null,"abstract":"<div><div>The development of immunotherapy in first-line therapy with anti-PD-1 and anti-PD-L1 has changed the first line treatment algorithm of advanced non-small cell lung cancer (NSCLC). The anti-PD-(L)1 atézolizumab, cemiplimaband pembrolizumab clearly improve the overall survival in NSCLC with high PD-L1 expression (> 50% of tumour cells), comparatively to cytotoxic chemotherapy. Combinations of anti-PD(L)-1 to platinum-based chemotherapy are superior to chemotherapy alone, regardless of PD-L1 level of expression. They represent the 1st line gold-standard when PD-L1 is expressed in less than 50% of tumour cells and might reduce the risk of early disease progression in comparison with pembrolizumab when PD-L1 > 50%. The room for anti-CTLA-4 + anti-PD(L)-1 combinations which are not available in France remains to be established. Immunotherapy still benefits only a minority of patients whose identification is imperfect, underscoring the need for new strategies based on new combinations amplifying the anti-tumour immune response as well as understanding the mechanisms of resistance to treatment in order to improve these results.</div></div>","PeriodicalId":53645,"journal":{"name":"Revue des Maladies Respiratoires Actualites","volume":"17 2","pages":"Pages 2S151-2S159"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145236539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Admission en unité de soins critiques et niveau de réanimation : application au cancer du poumon ? 重症监护住院和复苏水平：肺癌的应用？

Q4 Medicine

Revue des Maladies Respiratoires Actualites

Pub Date : 2025-10-01 DOI: 10.1016/S1877-1203(25)00088-6

G. Dumas , C. Ardin , G. Berardi , F. Gonzalez , A.-C. Toffart

Patients with lung cancer are at high risk of developing organ failures, either directly related to the disease itself or as a consequence of its treatment, which may require admission to the intensive care unit (ICU). Such an event represents a major turning point in the patient's care pathway and remains associated with high morbidity and mortality. Recently, advances in targeted therapies and immunotherapy have significantly altered the clinical trajectory of patients with non-small cell lung cancer, prompting a reevaluation of ICU admission strategies, particularly in the context of acute respiratory failure. ICU admission decisions—as well as the intensity of organ support—must always be individualized and based on a tripartite discussion between the patient, the intensivist, and the oncologist. The aim is to establish a realistic and personalized care plan. Key elements in this decision-making process include the assessment of patient frailty, the tumor history, the number and expected reversibility of organ failures (and their underlying causes), as well as the patient's goals and family expectations.

In this review, we summarize the factors associated with ICU survival in patients with bronchial cancer—whether patient-related, tumor-related, or linked to the acute event. We then focus on the specific case of acute respiratory failure, examining its reversibility, prognosis, and the etiologic and supportive therapies that should be considered. 1877-1203/© 2025 SPLF. Published by Elsevier Masson SAS. All rights reserved.

肺癌患者发生器官衰竭的风险很高，这要么与疾病本身直接相关，要么是治疗的结果，这可能需要入住重症监护病房（ICU）。这种事件代表了患者护理途径的一个重大转折点，并仍然与高发病率和死亡率有关。最近，靶向治疗和免疫治疗的进展显著地改变了非小细胞肺癌患者的临床轨迹，促使对ICU入院策略的重新评估，特别是在急性呼吸衰竭的情况下。ICU的入院决定——以及器官支持的强度——必须始终是个体化的，并基于患者、重症医师和肿瘤学家三方的讨论。目的是建立一个现实的和个性化的护理计划。这一决策过程中的关键因素包括评估患者的虚弱程度、肿瘤病史、器官衰竭的数量和预期的可逆性（及其潜在原因），以及患者的目标和家人的期望。在这篇综述中，我们总结了与支气管癌患者ICU生存相关的因素，无论是患者相关的、肿瘤相关的还是与急性事件相关的。然后我们将重点放在急性呼吸衰竭的具体病例上，检查其可逆性、预后以及应考虑的病因学和支持性治疗。1877-1203/©2025 splf。Elsevier Masson SAS出版。版权所有。

{"title":"Admission en unité de soins critiques et niveau de réanimation : application au cancer du poumon ?","authors":"G. Dumas , C. Ardin , G. Berardi , F. Gonzalez , A.-C. Toffart","doi":"10.1016/S1877-1203(25)00088-6","DOIUrl":"10.1016/S1877-1203(25)00088-6","url":null,"abstract":"<div><div>Patients with lung cancer are at high risk of developing organ failures, either directly related to the disease itself or as a consequence of its treatment, which may require admission to the intensive care unit (ICU). Such an event represents a major turning point in the patient's care pathway and remains associated with high morbidity and mortality. Recently, advances in targeted therapies and immunotherapy have significantly altered the clinical trajectory of patients with non-small cell lung cancer, prompting a reevaluation of ICU admission strategies, particularly in the context of acute respiratory failure. ICU admission decisions—as well as the intensity of organ support—must always be individualized and based on a tripartite discussion between the patient, the intensivist, and the oncologist. The aim is to establish a realistic and personalized care plan. Key elements in this decision-making process include the assessment of patient frailty, the tumor history, the number and expected reversibility of organ failures (and their underlying causes), as well as the patient's goals and family expectations.</div><div>In this review, we summarize the factors associated with ICU survival in patients with bronchial cancer—whether patient-related, tumor-related, or linked to the acute event. We then focus on the specific case of acute respiratory failure, examining its reversibility, prognosis, and the etiologic and supportive therapies that should be considered. 1877-1203/© 2025 SPLF. Published by Elsevier Masson SAS. All rights reserved.</div></div>","PeriodicalId":53645,"journal":{"name":"Revue des Maladies Respiratoires Actualites","volume":"17 2","pages":"Pages 2S305-2S310"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145236609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Revue des Maladies Respiratoires Actualites

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀