摘要
小細胞肺癌在所有肺癌中佔了15%，但只有為數不多的治療選項，且治療預後也較差。過去傳統的治療以etoposide合併含鉑類藥物的化學治療為主。最近，免疫檢查點抑制劑被證實可改善廣泛期小細胞肺癌病人治療的預後。根據IMPOWER133與CASPIAN，未接受治療的廣泛期小細胞肺癌病人，在傳統的化學治療加上atezolizumab或durvalumab可以明顯改善病人的整體存活期。然而，在KEYNOTE 604中，化學治療加上pembrolizumab雖然可延長病人的無惡化存活期，但是對整體存活期並無顯著的改善。根據CheckMate 032及KEYNOTE028／158中，針對含鉑類藥物化學治療及另一線治療失敗的廣泛期小細胞肺癌病人，nivolumab／nivolumab加ipilimumab和pembrolizumab可以提供良好的抗癌作用。本文將回顧免疫檢查點抑制劑在小細胞肺癌的治療，進一部探討其治療的成效。
並列摘要
Small cell lung cancer (SCLC) accounts for about 15% of lung cancers and has limited therapeutic options and poor prognosis. The traditional treatment of this aggressive tumor is platinum based chemotherapy with etoposide. Immune checkpoint inhibitors are the first agents in the last decades to improve the outcomes of patients with extensive stage (ES) SCLC patients. In IMPOWER 133 and CASPIAN, the addition of atezolizumab or durvalumab to etoposide with platinum based chemotherapy produced a significant improvement in overall survival in previously untreated patients with ES-SCLC. However, the KEYNOTE 604 study revealed that the addition of pembrolizumab to chemotherapy failed to significantly improve overall survival, but it prolonged progression-free survival. Nivolumab/nivolumab plus ipilimumab and pembrolizumab single agents showed anti-tumor activity in CheckMate 032 and KEYNOTE 028/158 trials in pretreated patients with SCLC. This review summarizes the main results of clinical trial with checkpoint inhibitors in SCLC.