Durvalumab：無法手術切除的第三期非小細胞肺癌於放射治療合併化療後之鞏固治療

Durvalumab: Consolidation Therapy after Concurrent Chemoradiotherapy in Unresectable Stage III Non-Small Cell Lung Cancer

關如珺(Ru-Jiun Guan)

《腫瘤護理雜誌》 19卷2期 (2019/12) Pp. 57-66

https://doi.org/10.6880/TJON.201912_19(2).04

摘要

肺癌在全球及台灣都是死亡率最高的癌症，轉移性非小細胞肺癌的治療在過去二十年發展出標靶及免疫藥物後已有很顯著的改善，但在無法手術切除的第三期非小細胞肺癌仍止於使用放射治療合併化療，在此標準治療後給予鞏固化療無法改善整體存活。Durvalumab是作用於PD-L1的免疫治療藥物，藉由阻斷腫瘤細胞的PD-L1與T細胞的PD-1結合，維持T細胞的活性，讓T細胞能夠攻擊腫瘤細胞而達到抗癌的效果，經臨床試驗證實，durvalumab作為無法手術切除的第三期非小細胞肺癌接受放射治療合併化療後疾病未惡化的鞏固治療可顯著改善整體存活，2018年美國食品藥品管理局、歐洲藥品管理局及台灣衛生福利部陸續核准使用。隨著免疫藥物種類、適應症及接受免疫治療的病人逐漸增加，如何處理免疫相關不良事件也是十分重要的課題。

關鍵字

durvalumab ； 非小細胞肺癌 ； 免疫檢查點抑制劑 ； 免疫相關不良事件

並列摘要

Lung cancer ranks top in cancer-related death worldwide and in Taiwan. The treatment of metastatic non-small cell lung cancer has improved significantly after the development of targeted therapy and immunotherapy in the past two decades. However, concurrent chemoradiotherapy is still the treatment of choice in unresectable stage III non-small cell lung cancer. Consolidation chemotherapy after concurrent chemoradiotherapy does not improve overall survival. Durvalumab is an immunotherapy agent that binds to PD-L1. It blocks the interaction of PD-L1 with PD-1, sustains the activity of T cell, and induces T-cell attack tumor cells to achieve anti-cancer effects. Clinical trials have confirmed that durvalumab, as consolidation therapy, improved overall survival significantly in patients with unresectable stage III non-small cell lung cancer who did not have disease progression after concurrent chemoradiotherapy. The US Food and Drug Administration, the European Medicines Agency, and The Ministry of Health and Welfare in Taiwan have approved its use in 2018. With the increasing types of immunotherapy agents, indications, and patients receiving immunotherapy, how to deal with immune-related adverse events is becoming a very important issue.

並列關鍵字

durvalumab ； non-small cell lung cancer ； immune checkpoint inhibitor ； immune-related adverse event

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