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老年及体能状态差的非小细胞肺癌治疗的近期进展综述

A Review of Recent Advances in the Treatment of Elderly and Poor Performance NSCLC.

作者信息

Carmichael Juliet A, Wing-San Mak Daisy, O'Brien Mary

机构信息

Lung Unit, Royal Marsden Hospital, Downs Rd, Sutton, Surrey SM2 5PT, UK.

Queen Elizabeth Hospital, 30 Gascoigne Road, Yau Ma Tei, Hong Kong, China.

出版信息

Cancers (Basel). 2018 Jul 18;10(7):236. doi: 10.3390/cancers10070236.

Abstract

Until recently, chemotherapy has remained the mainstay of treatment for the majority of patients with advanced non-small cell lung cancer (NSCLC). Excellent responses have been observed with immune-checkpoint inhibitors, and targeted treatments for those tumours with actionable mutations, resulting in a paradigm shift in the treatment approach for these patients. Elderly patients and those with poor performance status (PS), such as Eastern Cooperative Oncology Group (ECOG) 2, have historically been excluded from clinical trials due to poor outcomes. There is therefore a lack of data to define the optimal treatment strategy for these patients. Due to improved tolerability of novel therapies, inclusion of these patients in clinical trials has increased, and sub-group analyses have identified many treatments demonstrating potential activity. Here, we summarise key recent advances in the treatment of NSCLC, specifically evaluating their efficacy and tolerability in these patient cohorts.

摘要

直到最近,化疗一直是大多数晚期非小细胞肺癌(NSCLC)患者的主要治疗手段。免疫检查点抑制剂已观察到显著疗效,针对具有可操作突变的肿瘤的靶向治疗也取得了成效,这导致了这些患者治疗方法的范式转变。老年患者以及体能状态较差(PS)的患者,如东部肿瘤协作组(ECOG)评分为2分的患者,由于预后较差,历来被排除在临床试验之外。因此,缺乏数据来确定这些患者的最佳治疗策略。由于新型疗法的耐受性有所提高,将这些患者纳入临床试验的情况有所增加,亚组分析也确定了许多显示出潜在活性的治疗方法。在此,我们总结了NSCLC治疗方面最近的关键进展,特别评估了它们在这些患者群体中的疗效和耐受性。

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