[Combination of Radiotherapy and Immunotherapy for Unresectable Stage III Non-small Cell Lung Cancer: Clinical Progress Advances and Future Directions].
Uloženo v:
| Název: | [Combination of Radiotherapy and Immunotherapy for Unresectable Stage III Non-small Cell Lung Cancer: Clinical Progress Advances and Future Directions]. |
|---|---|
| Autoři: | Tan Z; Graduate Collaborative Training Base of Hunan Cancer Hospital, University of South China, Hengyang Medical School, Hengyang 421001, China.; The Second Department of Thoracic Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China., Zhong Y; Graduate Collaborative Training Base of Hunan Cancer Hospital, University of South China, Hengyang Medical School, Hengyang 421001, China.; The Second Department of Thoracic Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China., Wang J; The Second Department of Thoracic Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China., Wu L; The Second Department of Thoracic Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China. |
| Zdroj: | Zhongguo fei ai za zhi = Chinese journal of lung cancer [Zhongguo Fei Ai Za Zhi] 2025 Nov 20; Vol. 28 (11), pp. 866-874. |
| Způsob vydávání: | Journal Article; Review; English Abstract |
| Jazyk: | Chinese |
| Informace o časopise: | Publisher: Zhongguo fei ai za zhi bian ji wei yuan hui Country of Publication: China NLM ID: 101126433 Publication Model: Print Cited Medium: Internet ISSN: 1999-6187 (Electronic) Linking ISSN: 10093419 NLM ISO Abbreviation: Zhongguo Fei Ai Za Zhi Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2008- : Tianjin Shi : Zhongguo fei ai za zhi bian ji wei yuan hui Original Publication: Chendu Shi : Zhongguo fei ai za zhi bian ji wei yuan hui |
| Výrazy ze slovníku MeSH: | Carcinoma, Non-Small-Cell Lung*/therapy , Carcinoma, Non-Small-Cell Lung*/radiotherapy , Carcinoma, Non-Small-Cell Lung*/pathology , Carcinoma, Non-Small-Cell Lung*/immunology , Lung Neoplasms*/therapy , Lung Neoplasms*/radiotherapy , Lung Neoplasms*/pathology , Lung Neoplasms*/immunology , Immunotherapy*/methods, Humans ; Combined Modality Therapy ; Neoplasm Staging |
| Abstrakt: | Stage III non-small cell lung cancer (NSCLC) accounts for approximately 30% of newly diagnosed NSCLC cases, and the vast majority of these patients present with unresectable disease. Its unresectable nature makes definitive chemoradiotherapy the cornerstone of treatment. In recent years, with immune checkpoint inhibitors (ICIs) becoming a major research focus in lung cancer, increasing evidence demonstrates that the combination of radiotherapy and immunotherapy (iRT) can significantly enhance antitumor efficacy through synergistic mechanisms. The groundbreaking results of the landmark PACIFIC trial further established consolidation immunotherapy following concurrent chemoradiotherapy as the standard of care. However, controversies persist regarding optimal radiotherapy strategies, timing of immune intervention, management of adverse reactions, and exploration of biomarkers. This review aims to systematically elucidate the synergistic mechanisms of iRT, summarize clinical trial advances under different iRT treatment modalities (concurrent, consolidation and induction), and provide an in-depth analysis of key issues in current clinical practice along with future research directions. . |
| References: | Lancet Oncol. 2025 Jan;26(1):85-97. (PMID: 39615497) Nat Rev Dis Primers. 2024 Sep 26;10(1):71. (PMID: 39327441) Int J Radiat Oncol Biol Phys. 2023 Oct 1;117(2):387-399. (PMID: 37100160) Semin Immunol. 2021 Feb;52:101474. (PMID: 33741223) N Engl J Med. 2018 Dec 13;379(24):2342-2350. (PMID: 30280658) Ann Oncol. 2019 Jan 1;30(1):44-56. (PMID: 30395155) Clin Cancer Res. 2024 Mar 15;30(6):1104-1110. (PMID: 38165684) Cell Death Dis. 2023 Oct 13;14(10):679. (PMID: 37833255) BMC Cancer. 2023 Oct 10;23(1):962. (PMID: 37817073) Ann Oncol. 2018 Jan 1;29(1):193-199. (PMID: 29361135) J Thorac Oncol. 2020 Feb;15(2):248-257. (PMID: 31778797) Nat Rev Cancer. 2020 Apr;20(4):203-217. (PMID: 32161398) J Hematol Oncol. 2025 Dec 7;18(1):111. (PMID: 41354932) Radiat Oncol. 2023 May 22;18(1):86. (PMID: 37217970) N Engl J Med. 2017 Nov 16;377(20):1919-1929. (PMID: 28885881) N Engl J Med. 2019 Mar 7;380(10):989-990. (PMID: 30855760) Nat Med. 2021 Feb;27(2):256-263. (PMID: 33558721) Nat Rev Cancer. 2018 May;18(5):313-322. (PMID: 29449659) J Clin Oncol. 2022 Apr 20;40(12):1301-1311. (PMID: 35108059) Lung Cancer. 2025 Jun;204:108583. (PMID: 40393235) Int J Radiat Oncol Biol Phys. 2024 Oct 1;120(2):422-431. (PMID: 38631536) Front Pharmacol. 2019 May 14;10:511. (PMID: 31156434) Zhongguo Fei Ai Za Zhi. 2020 Jun 20;23(6):532-540. (PMID: 32517461) NPJ Precis Oncol. 2024 Dec 24;8(1):290. (PMID: 39719541) Immunity. 2019 Jan 15;50(1):195-211.e10. (PMID: 30635237) Lancet Oncol. 2022 Feb;23(2):209-219. (PMID: 35038429) Cancers (Basel). 2021 Dec 08;13(24):. (PMID: 34944813) BMC Cancer. 2021 Jul 16;21(1):824. (PMID: 34271861) Cell Commun Signal. 2023 May 23;21(1):119. (PMID: 37221584) J Clin Oncol. 2022 Oct 10;40(29):3383-3393. (PMID: 35452273) JAMA Oncol. 2024 Mar 1;10(3):352-359. (PMID: 38206614) Lancet Oncol. 2018 Sep;19(9):1180-1191. (PMID: 30120041) Med. 2023 Apr 14;4(4):233-244. (PMID: 36893753) J Natl Cancer Cent. 2024 Apr 10;4(2):177-187. (PMID: 39282582) ESMO Open. 2025 Jun;10(6):105071. (PMID: 40435873) JAMA Oncol. 2024 Sep 1;10(9):1212-1219. (PMID: 39052256) Lung Cancer. 2022 Dec;174:112-117. (PMID: 36371941) Anticancer Res. 2020 Jan;40(1):379-386. (PMID: 31892590) J Immunother Cancer. 2022 Mar;10(3):. (PMID: 35256515) Ann Oncol. 2009 Jan;20(1):98-102. (PMID: 18718891) Nat Rev Cancer. 2020 Sep;20(9):516-531. (PMID: 32632251) Cancer. 2020 Oct 1;126(19):4353-4361. (PMID: 32697352) J Hematol Oncol. 2018 Aug 16;11(1):104. (PMID: 30115069) BMC Cancer. 2024 Jan 15;24(1):78. (PMID: 38225543) Actas Dermosifiliogr (Engl Ed). 2021 Jan;112(1):90-92. (PMID: 32891586) Int J Radiat Oncol Biol Phys. 2020 Sep 1;108(1):212-224. (PMID: 32417411) Int J Radiat Oncol Biol Phys. 2025 Jun 1;122(2):383-391. (PMID: 39921110) Future Oncol. 2024;20(29):2137-2147. (PMID: 39023287) Zhongguo Fei Ai Za Zhi. 2024 Jun 20;27(6):459-465. (PMID: 39026497) Curr Opin Immunol. 2016 Apr;39:7-13. (PMID: 26708937) J Thorac Oncol. 2021 May;16(5):860-867. (PMID: 33476803) Cancer Immunol Res. 2015 Apr;3(4):345-55. (PMID: 25527358) Curr Probl Cancer. 2016 Jan-Feb;40(1):25-37. (PMID: 26582738) Clin Lung Cancer. 2022 Sep;23(6):e342-e346. (PMID: 35618629) Int J Mol Sci. 2021 Oct 14;22(20):. (PMID: 34681719) Front Pharmacol. 2023 Jun 08;14:1103927. (PMID: 37361225) J Thorac Oncol. 2023 Feb;18(2):181-193. (PMID: 36307040) Clinics (Sao Paulo). 2018 Dec 10;73(suppl 1):e557s. (PMID: 30540123) Lung Cancer. 2019 Jul;133:83-87. (PMID: 31200833) |
| Contributed Indexing: | Keywords: Biomarkers; Immune checkpoint inhibitors; Immunotherapy; Lung neoplasms; Radiotherapy Local Abstract: [Publisher, Chinese] 【中文题目：放疗联合免疫治疗在不可切除III期 非小细胞肺癌中的临床研究进展及未来展望】 【中文摘要：III期非小细胞肺癌（non-small cell lung cancer, NSCLC）约占初诊NSCLC的30%，且绝大多数患者无法手术切除，其不可手术特性使根治性放化疗成为核心治疗手段。近年来，随着免疫检查点抑制剂（immune checkpoint inhibitors, ICIs）成为肺癌领域的研究热点，越来越多的研究表明放疗联合免疫治疗（combination of radiotherapy and immunotherapy, iRT）能通过协同机制显著提升抗肿瘤疗效，PACIFIC研究的突破性进展更确立了同步放化疗后免疫巩固治疗的标准地位。然而，最佳放疗策略、免疫介入时机、不良事件管理和生物标志物探索等问题仍存争议。本综述旨在系统阐述iRT的协同作用机制，梳理不同iRT治疗模式下（同步、巩固、诱导）的临床试验进展，并对当前临床实践中的关键问题与未来研究方向进行深入探讨。 】 【中文关键词：肺肿瘤；放疗；免疫治疗；免疫检查点抑制剂；生物标志物】. |
| Entry Date(s): | Date Created: 20260202 Date Completed: 20260202 Latest Revision: 20260211 |
| Update Code: | 20260211 |
| PubMed Central ID: | PMC12883981 |
| DOI: | 10.3779/j.issn.1009-3419.2025.102.42 |
| PMID: | 41622934 |
| Databáze: | MEDLINE |
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| Items | – Name: Title Label: Title Group: Ti Data: [Combination of Radiotherapy and Immunotherapy for Unresectable Stage III Non-small Cell Lung Cancer: Clinical Progress Advances and Future Directions]. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AU" term="%22Tan+Z%22">Tan Z</searchLink>; Graduate Collaborative Training Base of Hunan Cancer Hospital, University of South China, Hengyang Medical School, Hengyang 421001, China.; The Second Department of Thoracic Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China.<br /><searchLink fieldCode="AU" term="%22Zhong+Y%22">Zhong Y</searchLink>; Graduate Collaborative Training Base of Hunan Cancer Hospital, University of South China, Hengyang Medical School, Hengyang 421001, China.; The Second Department of Thoracic Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China.<br /><searchLink fieldCode="AU" term="%22Wang+J%22">Wang J</searchLink>; The Second Department of Thoracic Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China.<br /><searchLink fieldCode="AU" term="%22Wu+L%22">Wu L</searchLink>; The Second Department of Thoracic Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China. – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22101126433%22">Zhongguo fei ai za zhi = Chinese journal of lung cancer</searchLink> [Zhongguo Fei Ai Za Zhi] 2025 Nov 20; Vol. 28 (11), pp. 866-874. – Name: TypePub Label: Publication Type Group: TypPub Data: Journal Article; Review; English Abstract – Name: Language Label: Language Group: Lang Data: Chinese – Name: TitleSource Label: Journal Info Group: Src Data: <i>Publisher: </i><searchLink fieldCode="PB" term="%22Zhongguo+fei+ai+za+zhi+bian+ji+wei+yuan+hui%22">Zhongguo fei ai za zhi bian ji wei yuan hui </searchLink><i>Country of Publication: </i>China <i>NLM ID: </i>101126433 <i>Publication Model: </i>Print <i>Cited Medium: </i>Internet <i>ISSN: </i>1999-6187 (Electronic) <i>Linking ISSN: </i><searchLink fieldCode="IS" term="%2210093419%22">10093419 </searchLink><i>NLM ISO Abbreviation: </i>Zhongguo Fei Ai Za Zhi <i>Subsets: </i>MEDLINE – Name: PublisherInfo Label: Imprint Name(s) Group: PubInfo Data: <i>Publication</i>: 2008- : Tianjin Shi : Zhongguo fei ai za zhi bian ji wei yuan hui<br /><i>Original Publication</i>: Chendu Shi : Zhongguo fei ai za zhi bian ji wei yuan hui – Name: SubjectMESH Label: MeSH Terms Group: Su Data: <searchLink fieldCode="MM" term="%22Carcinoma%2C+Non-Small-Cell+Lung%22">Carcinoma, Non-Small-Cell Lung*</searchLink>/<searchLink fieldCode="MM" term="%22Carcinoma%2C+Non-Small-Cell+Lung+therapy%22">therapy</searchLink> <br /><searchLink fieldCode="MM" term="%22Carcinoma%2C+Non-Small-Cell+Lung%22">Carcinoma, Non-Small-Cell Lung*</searchLink>/<searchLink fieldCode="MM" term="%22Carcinoma%2C+Non-Small-Cell+Lung+radiotherapy%22">radiotherapy</searchLink> <br /><searchLink fieldCode="MM" term="%22Carcinoma%2C+Non-Small-Cell+Lung%22">Carcinoma, Non-Small-Cell Lung*</searchLink>/<searchLink fieldCode="MM" term="%22Carcinoma%2C+Non-Small-Cell+Lung+pathology%22">pathology</searchLink> <br /><searchLink fieldCode="MM" term="%22Carcinoma%2C+Non-Small-Cell+Lung%22">Carcinoma, Non-Small-Cell Lung*</searchLink>/<searchLink fieldCode="MM" term="%22Carcinoma%2C+Non-Small-Cell+Lung+immunology%22">immunology</searchLink> <br /><searchLink fieldCode="MM" term="%22Lung+Neoplasms%22">Lung Neoplasms*</searchLink>/<searchLink fieldCode="MM" term="%22Lung+Neoplasms+therapy%22">therapy</searchLink> <br /><searchLink fieldCode="MM" term="%22Lung+Neoplasms%22">Lung Neoplasms*</searchLink>/<searchLink fieldCode="MM" term="%22Lung+Neoplasms+radiotherapy%22">radiotherapy</searchLink> <br /><searchLink fieldCode="MM" term="%22Lung+Neoplasms%22">Lung Neoplasms*</searchLink>/<searchLink fieldCode="MM" term="%22Lung+Neoplasms+pathology%22">pathology</searchLink> <br /><searchLink fieldCode="MM" term="%22Lung+Neoplasms%22">Lung Neoplasms*</searchLink>/<searchLink fieldCode="MM" term="%22Lung+Neoplasms+immunology%22">immunology</searchLink> <br /><searchLink fieldCode="MM" term="%22Immunotherapy%22">Immunotherapy*</searchLink>/<searchLink fieldCode="MM" term="%22Immunotherapy+methods%22">methods</searchLink><br /><searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink> ; <searchLink fieldCode="MH" term="%22Combined+Modality+Therapy%22">Combined Modality Therapy</searchLink> ; <searchLink fieldCode="MH" term="%22Neoplasm+Staging%22">Neoplasm Staging</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Stage III non-small cell lung cancer (NSCLC) accounts for approximately 30% of newly diagnosed NSCLC cases, and the vast majority of these patients present with unresectable disease. Its unresectable nature makes definitive chemoradiotherapy the cornerstone of treatment. In recent years, with immune checkpoint inhibitors (ICIs) becoming a major research focus in lung cancer, increasing evidence demonstrates that the combination of radiotherapy and immunotherapy (iRT) can significantly enhance antitumor efficacy through synergistic mechanisms. The groundbreaking results of the landmark PACIFIC trial further established consolidation immunotherapy following concurrent chemoradiotherapy as the standard of care. However, controversies persist regarding optimal radiotherapy strategies, timing of immune intervention, management of adverse reactions, and exploration of biomarkers. This review aims to systematically elucidate the synergistic mechanisms of iRT, summarize clinical trial advances under different iRT treatment modalities (concurrent, consolidation and induction), and provide an in-depth analysis of key issues in current clinical practice along with future research directions. . – Name: Ref Label: References Group: RefInfo Data: Lancet Oncol. 2025 Jan;26(1):85-97. (PMID: <searchLink fieldCode="PM" term="%2239615497%22">39615497)</searchLink><br />Nat Rev Dis Primers. 2024 Sep 26;10(1):71. (PMID: <searchLink fieldCode="PM" term="%2239327441%22">39327441)</searchLink><br />Int J Radiat Oncol Biol Phys. 2023 Oct 1;117(2):387-399. (PMID: <searchLink fieldCode="PM" term="%2237100160%22">37100160)</searchLink><br />Semin Immunol. 2021 Feb;52:101474. (PMID: <searchLink fieldCode="PM" term="%2233741223%22">33741223)</searchLink><br />N Engl J Med. 2018 Dec 13;379(24):2342-2350. 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(PMID: <searchLink fieldCode="PM" term="%2231200833%22">31200833)</searchLink> – Name: SubjectMinor Label: Contributed Indexing Group: Data: <i>Keywords: </i>Biomarkers; Immune checkpoint inhibitors; Immunotherapy; Lung neoplasms; Radiotherapy<br /><i>Local Abstract: </i>[Publisher, Chinese] 【中文题目：放疗联合免疫治疗在不可切除III期 非小细胞肺癌中的临床研究进展及未来展望】 【中文摘要：III期非小细胞肺癌（non-small cell lung cancer, NSCLC）约占初诊NSCLC的30%，且绝大多数患者无法手术切除，其不可手术特性使根治性放化疗成为核心治疗手段。近年来，随着免疫检查点抑制剂（immune checkpoint inhibitors, ICIs）成为肺癌领域的研究热点，越来越多的研究表明放疗联合免疫治疗（combination of radiotherapy and immunotherapy, iRT）能通过协同机制显著提升抗肿瘤疗效，PACIFIC研究的突破性进展更确立了同步放化疗后免疫巩固治疗的标准地位。然而，最佳放疗策略、免疫介入时机、不良事件管理和生物标志物探索等问题仍存争议。本综述旨在系统阐述iRT的协同作用机制，梳理不同iRT治疗模式下（同步、巩固、诱导）的临床试验进展，并对当前临床实践中的关键问题与未来研究方向进行深入探讨。 】 【中文关键词：肺肿瘤；放疗；免疫治疗；免疫检查点抑制剂；生物标志物】. – Name: DateEntry Label: Entry Date(s) Group: Date Data: <i>Date Created: </i>20260202 <i>Date Completed: </i>20260202 <i>Latest Revision: </i>20260211 – Name: DateUpdate Label: Update Code Group: Date Data: 20260211 – Name: PubmedCentralID Label: PubMed Central ID Group: ID Data: PMC12883981 – Name: DOI Label: DOI Group: ID Data: 10.3779/j.issn.1009-3419.2025.102.42 – Name: AN Label: PMID Group: ID Data: 41622934 |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.3779/j.issn.1009-3419.2025.102.42 Languages: – Code: chi Text: Chinese PhysicalDescription: Pagination: StartPage: 866 Subjects: – SubjectFull: Humans Type: general – SubjectFull: Combined Modality Therapy Type: general – SubjectFull: Neoplasm Staging Type: general – SubjectFull: Carcinoma, Non-Small-Cell Lung therapy Type: general – SubjectFull: Carcinoma, Non-Small-Cell Lung radiotherapy Type: general – SubjectFull: Carcinoma, Non-Small-Cell Lung pathology Type: general – SubjectFull: Carcinoma, Non-Small-Cell Lung immunology Type: general – SubjectFull: Lung Neoplasms therapy Type: general – SubjectFull: Lung Neoplasms radiotherapy Type: general – SubjectFull: Lung Neoplasms pathology Type: general – SubjectFull: Lung Neoplasms immunology Type: general – SubjectFull: Immunotherapy methods Type: general Titles: – TitleFull: [Combination of Radiotherapy and Immunotherapy for Unresectable Stage III Non-small Cell Lung Cancer: Clinical Progress Advances and Future Directions]. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Tan Z – PersonEntity: Name: NameFull: Zhong Y – PersonEntity: Name: NameFull: Wang J – PersonEntity: Name: NameFull: Wu L IsPartOfRelationships: – BibEntity: Dates: – D: 20 M: 11 Text: 2025 Nov 20 Type: published Y: 2025 Identifiers: – Type: issn-electronic Value: 1999-6187 Numbering: – Type: volume Value: 28 – Type: issue Value: 11 Titles: – TitleFull: Zhongguo fei ai za zhi = Chinese journal of lung cancer Type: main |
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