The advent of immunotherapy has transformed the treatment paradigm for metastatic non-small cell lung cancer (NSCLC). In the past few years, several studies have investigated the potential role of immune checkpoint inhibitors (ICIs) in resectable and unresectable locally advanced disease, achieving remarkable results that led to their approval in clinical practice. However, there is limited evidence on immunotherapy rechallenge after recurrence, with the majority of available knowledge coming from retrospective studies which involve heavily pretreated patients with advanced NSCLC. The recent introduction in the curative setting and the potential regulatory restrictions raise questions about the optimal choice of first-line and subsequent therapies for patients with systemic relapse. The role of immunotherapy readministration in this new scenario needs to be clarified, as well as the identification of patients for whom it is more appropriate, including clinical characteristics, duration of response, switching to other ICIs, reasons for discontinuation and immune-related toxicity. Here, we review literature on rechallenge with immunotherapy, including efficacy, safety profile and potential predictive factors of response.
免疫疗法的出现改变了转移性非小细胞肺癌（NSCLC）的治疗模式。近年来，多项研究探讨了免疫检查点抑制剂（ICIs）在可切除与不可切除局部晚期疾病中的潜在作用，并取得了显著成果，使其在临床实践中获得应用批准。然而，关于复发后免疫疗法再挑战的证据仍然有限，现有认知主要来源于针对经过多线治疗的晚期NSCLC患者的回顾性研究。随着免疫疗法近期在根治性治疗中的应用以及潜在的监管限制，关于全身性复发患者一线及后续治疗的最佳选择引发了新的疑问。在这一新背景下，免疫疗法再次给药的作用亟待明确，同时需要确定更适合接受该治疗的患者群体，包括其临床特征、应答持续时间、转换为其他ICIs的可行性、治疗中止原因及免疫相关毒性等。本文综述了关于免疫疗法再挑战的现有文献，涵盖其疗效、安全性特征以及潜在的应答预测因素。
肿瘤(癌症)患者之家