[ELCC 2015]吴一龙教授和Manegold教授共话NSCLC免疫疗法

作者:肿瘤瞭望   日期:2015/4/22 17:53:30  浏览量:32086

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编者按:关于NSCLC免疫治疗,本届ELCC在16日的日程中专门设置了一个辩论环节:“免疫治疗是NSCLC的一线治疗选择吗?”这个有趣的学术博弈吸引了众多与会者的目光,正反双方的辩论精彩而激烈。该环节的辩论结束后,参会专家们仍意犹未尽。CSCO现任主任委员、广东省人民医院副院长吴一龙教授现场采访了Christian Manegold教授,征询了他对免疫治疗地位的看法。Manegold教授是德国海德堡大学医学教授、IASLC董事会成员。

  吴一龙教授:您如何看待晚期非小细胞肺癌(NSCLC)的免疫治疗?

 

  Manegold教授:免疫系统可影响肿瘤的生长,关于如何使用免疫疗法控制肿瘤生长和治愈患者,我们已经尝试了几十年,但是疫苗和许多免疫调节剂未能取得好的疗效。目前有前景、新的免疫疗法是检查点抑制剂,也出现了新的疫苗接种策略,免疫治疗策略正在被转化为临床实践。目前仍不确定免疫治疗的靶点和作用机制(黑色素瘤等肿瘤的免疫治疗研究更加明确),但免疫疗法是今后NSCLC治疗的正确方向。

 

  吴一龙教授:你认为免疫治疗能否成为NSCLC一线治疗方案?

 

  Manegold教授:我认为,如果药物疗效好就应该用在一线。目前临床上没把免疫疗法用在一线,而是用于二线或二线以上。最终,各种新的、可用的免疫疗法会被用于一线治疗。不是单独使用免疫疗法治疗NSCLC,而是与其他疗法(如放疗、化疗)联合,或者不同的免疫方法之间进行联合。

 

  英文原文

 

  Prof. Wu:  Oncology Frontier: What are your thoughts on immunotherapy in the treatment of advanced NSCLC?


  Dr Manegold: Immunology greatly influences tumor growth. We have tried for decades to use immunotherapeutic approaches to control tumor growth and cure patients, but vaccinations and many other forms of immune modulators have failed to help us manage tumors in patients. At the moment, we are facing an interesting time with regard to new approaches in immunotherapy with the checkpoint inhibitors. We also have interesting new vaccination strategies. We are at the beginning of incorporating these strategies into clinical practice. We still don’t know with certainty the targets and mechanisms of action but for some tumors, like melanoma, we know a lot more than for non-small cell lung cancer, for example. But we are on the right track with non-small cell lung cancer to be using these new immunotherapeutic approaches successfully.

 

  Prof. Wu: Would you foresee immunotherapy as a first-line treatment strategy for NSCLC?

 

  Dr Manegold: I think that if you have a good drug, you should use it first-line. Clinical developments do not usually start in the first-line but with second- or subsequent-line therapy. But at the end of the day, I think we will have these new immunological approaches available not only for second- and subsequent-line therapy but also in the first-line. It is not a matter of the immune approach alone, but maybe a combination with chemotherapy and radiotherapy will be necessary or maybe even of different immune approaches for non-small cell lung cancer.

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