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  • 朱顺沧,宋楠.病理缓解在可切除非小细胞肺癌新辅助治疗中的研究进展[J].同济大学学报(医学版),2021,42(5):698-704.    [点击复制]
  • ZHU Shun-cang,SONG Nan.Research advances on application of pathologic response as an efficacy endpoint for neoadjuvant therapy in resectable non-small-cell lung cancer[J].同济大学学报(医学版),2021,42(5):698-704.   [点击复制]
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病理缓解在可切除非小细胞肺癌新辅助治疗中的研究进展
朱顺沧,宋楠
0
(同济大学附属上海市肺科医院胸外科,上海200433)
摘要:
近年来,尽管可切除非小细胞肺癌(non-small-cell lung cancer, NSCLC)的治疗方式不断取得进展,但在以总生存期(overall survival, OS)和无病生存期(disease-free survival, DFS)为主要终点的相关临床试验中,漫长的试验周期一定程度上限制了NSCLC的治疗进展。为加快抗癌药物研发进程,让更多患者及早获益,临床研究中急需一个能够快速评估NSCLC治疗效果的评价指标。而NSCLC经新辅助治疗后,其原发病灶可通过手术切除进行病理学评估的独特性,使得将病理缓解作为OS的替代终点成为可能。本文总结病理缓解作为可切除NSCLC新辅助化学治疗、放射治疗、靶向治疗及免疫治疗中的疗效评价指标的应用概况,探讨其作为OS替代终点的可行性。
关键词:  非小细胞肺癌  新辅助治疗  病理完全缓解  主要病理缓解  替代终点
DOI:10.12289/j.issn.1008-0392.20324
投稿时间:2020-07-26
基金项目:上海市科学技术委员会项目(19XD1423200);上海市肺科医院“肺癌诊疗中心”项目
Research advances on application of pathologic response as an efficacy endpoint for neoadjuvant therapy in resectable non-small-cell lung cancer
ZHU Shun-cang,SONG Nan
(Dept. of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai 200433, China)
Abstract:
Recently, the treatment effectiveness for resectable non-small-cell lung cancer(NSCLC) has been continuously improved. However, the long-term trial periods have limited the treatment progress of NSCLC to some extent, because most of relevant clinical trials use overall survival(OS) and disease-free survival(DFS) as the primary endpoints. In order to speed up the development of anticancer drugs and bring benefits to more patients earlier, there are urgent needs of new endpoints that can quickly evaluate the therapeutic efficacy in cancer clinical trials. The pathological assessment can be available using the primary lesions resected during surgery in patients undergoing neoadjuvant therapy, so it is possible that the pathologic response become a new surrogate endpoint for OS. In this article we review the research progress of application of pathologic response as an evaluation index in neoadjuvant chemotherapy, radiotherapy, targeted therapy and immunotherapy for resectable NSCLC, and discuss its feasibility as an surrogate endpoint for OS.
Key words:  non-small-cell lung cancer  neoadjuvant therapy  pathologic complete response  major pathologic response  surrogate endpoint

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