Адъювантная иммунотерапия операбельного немелкоклеточного рака легкого: достижения и перспективы лечения

Рак легкого является одной из наиболее распространенных злокачественных опухолей с самой высокой смертностью, при этом около 85% случаев заболевания приходится на немелкоклеточный рак легкого. На сегодняшний день адъювантная химиотерапия на основе препаратов платины остается стандартом лечения пациентов с радикально прооперированным немелкоклеточным раком легкого (НМРЛ) II или III стадий. Однако у большой части пациентов по-прежнему имеется риск развития рецидива рака легкого даже после полной резекции опухоли. Именно поэтому существует необходимость в поиске новых методов лечения ранних стадий НМРЛ, что позволит свести к минимуму вероятность прогрессирования и улучшить выживаемость у потенциально излечиваемой группы пациентов. Уже сегодня клинические исследования начинают продвигать лечение немелкоклеточного рака легкого на ранних стадиях за рамки стандартной цитотоксической химиотерапии. Иммунотерапия, представленная ингибиторами иммунных контрольных точек, изучается во все большем количестве клинических исследований у пациентов с операбельным НМРЛ на ранних стадиях, постепенно обогащая уже существующие методы лечения. При этом некоторые вопросы, касающиеся адъювантной иммунотерапии, предстоит изучить: выбор препарата, применение монотерапии или комбинированных схем лечения. В этом обзоре рассматривается прогресс исследований, направленных на совершенствование адъювантной терапии благодаря включению ингибиторов иммунных контрольных точек в лечение ранних стадий операбельного немелкоклеточного рака легкого. Адъювантная иммунотерапия может улучшить безрецидивную выживаемость у отдельных пациентов с операбельным раком легкого, а текущие или планируемые исследования с использованием биомаркеров и иммунотерапии могут также в конечном счете привести к улучшению и общей выживаемости данной группы пациентов.

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