Immune checkpoint inhibitors (ICIs) have revolutionized the management of non-oncogene addicted non-small-cell lung cancer (NSCLC). Blocking the anti-PD-1 axis represents the current standard of care in the first-line setting, with drugs administered either as monotherapy or in combination with chemotherapy. Despite notable successes achieved with ICIs, most of their long-term benefits are restricted to approximately 20% of patients. Consequently, the post-failure treatment landscape after failure to first-line treatment remains a complex challenge. Currently, docetaxel remains the preferred option, although its benefits remain modest as most patients do not respond or progress promptly. In recent times, novel agents and treatment combinations have emerged, offering fresh opportunities to improve patient outcomes. ICIs combined either with antiangiogenic or other novel immunotherapeutic compounds have shown promising preliminary activity. However, more mature data concerning specific combinations do not support their benefit over standard of care. In addition, antibody–drug conjugates seem to be the most promising alternative among all available compounds according to already-published phase I/II data that will be confirmed in soon-to-be-published phase III trial data. In this report, we provide a comprehensive overview of the current second-line treatment options and discuss future therapeutic perspectives.
免疫检查点抑制剂（ICIs）已彻底改变了非致癌基因依赖型非小细胞肺癌（NSCLC）的治疗格局。阻断抗PD-1轴已成为一线治疗的标准方案，药物可单用或与化疗联合使用。尽管ICIs取得了显著成功，但其长期获益主要局限于约20%的患者。因此，一线治疗失败后的后续治疗策略仍是复杂挑战。目前多西他赛仍是首选方案，但其疗效有限，多数患者无法产生应答或迅速进展。近年来新型药物及联合治疗方案不断涌现，为改善患者预后提供了新机遇。ICIs联合抗血管生成药物或其他新型免疫治疗药物已显示出初步活性，但特定联合方案的成熟数据尚未证实其疗效优于标准治疗。此外，根据已公布的I/II期研究数据，抗体偶联药物在所有可用化合物中前景最为广阔，该结论即将通过III期试验数据得到验证。本报告系统综述当前二线治疗方案，并对未来治疗前景进行展望。
肿瘤(癌症)患者之家