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Objective:To evaluate the efficacy and safety of programmed death 1 (PD-1), programmed death ligand 1 (PD-L1) immune checkpoint inhibitor (ICI) monotherapy for brain metastasis in advanced non-small cell lung cancer (NSCLC), and to explore the timing of immunomonotherapy and the application of hormone on the efficacy of ICI.Methods:By searching literature in CNKI, Wanfang, VIP, PubMed, CBM, Embase, Cochrane Library and Web of Science databases, the advanced NSCLC patients with brain metastasis who received ICI treatment were identified, including patients with symptomatic brain metastasis who had received hormone therapy or brain surgery or radiotherapy. Meta-analysis was performed on the collected data to evaluate the systemic objective response rate (sORR) and intracerebral tumor objective response rate (iORR), the iORR of whether ICI monotherapy was first-line therapy, and the iORR of whether hormone was used were evaluated, and the incidence of adverse reactions was evaluated.Results:Fifteen studies were finally included, with a total of 4 033 patients, including 917 patients with brain metastasis. The iORR of immunomonotherapy was 26% (95% CI 19%-34%) and the sORR was 28% (95% CI 18%-40%). The iORR of first-line immunomonotherapy was 49% (95% CI 39%-58%). The iORR of symptomatic patients with hormone therapy and asymptomatic patients without hormone therapy was 26% (95% CI 20%-33%) and 19% (95% CI 16%-22%), respectively. The overall incidence of grade 3-4 adverse reactions was 14% (95% CI 11%-17%). Conclusions:The efficacy of ICI monotherapy in the first-line treatment of PD-L1-positive NSCLC patients with brain metastasis is better than that in the subsequent line therapy, and the application of hormone does not affect the efficacy of ICI. ICI monotherapy in the treatment of advanced NSCLC patients with brain metastasis is safe.
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With the development of biomolecular diagnostic technology and genetic analysis, it has been gradually discovered that some gene abnormalities can drive the occurrence and development of lung cancer. Among them, epidermal growth factor receptor (EGFR) is the most common mutant gene in non-small cell lung cancer (NSCLC). However, most of the current researches focus on the common mutations of EGFR, such as exon 19 deletion (19del) and exon 21 point mutation (L858R). There are few studies on rare EGFR mutations. This article reviews the progress of rare EGFR mutations in NSCLC.
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Objective To investigate the expression and clinical significance of Th17 and Tc17 cells in peripheral blood of lung cancer patients.Methods The percentages of Th17 cells and Tc17 cells in 60 lung cancer patients and 40 healthy controls were evaluated by flow cytometry analysis (FCM).Results The percentages of Th17 cells [(1.795±0.623) ％] and Te17 cells [(0.865±0.357) ％] in lung cancer group were significandy higher than those in controls [(1.405±0.256) ％,(0.640 ±0.204) ％],(t =28.944,P ＜ 0.001,t =14.051,P ＜ 0.001).Furthermore,there was a positive correlation between Th17 cells and Tc17 cells in the two groups (lung cancer group r =0.770,P ＜ 0.05,control group r =0.532,P ＜ 0.05).The percentages of Th17 cells and Tc17 cells were closely associated with clinical stage (F =4.882,P =0.011,F =3.633,P =0.033),but not connected with pathological types (P ＞ 0.05,P ＞ 0.05).Conclusion The overexpression of Th17 and Tc17 may be involved in the occurrence and development of lung cancer,which can be used as new indicators for immunologic function of lung cancer patients,and provide a reference in monitoring the disease.
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To know CD+4 CD+25 regulatory T cells' s function in tumor immunological regulation and to search for its functionary molecule mechanism by reviewing researches associated with the characteristics of CD+4 CD+25 regulatory T cells surface molecules and the expression of CD+4 CD+25 regulatory T cells in the peripheral blood and tissues.