Возможность применения тактики “watch and wait” в терапии пациентов с немелкоклеточным раком легкого (обзорная статья)
https://doi.org/10.18027/2224-5057-2026-075
Аннотация
Цель: Анализ мировых научных публикаций, посвященных методу “watch and wait” и перспективе его применения в группе пациентов с местнораспространенной формой НМРЛ.
Материал и методы: Произведен поиск литературы с использованием медицинских баз данных: PubMed, Web of Science, РИНЦ, Scopus. Включение публикаций осуществлялось исходя из следующих критериев: рандомизированные и когортные исследования, систематические обзоры и мета-анализы.
Выводы: Тактика “watch and wait” является перспективной опцией в терапии пациентов с НМРЛ и требует более глубокого изучения. Необходимо проведение проспективных исследований для определения ключевых параме‑ тров (критерии отбора пациентов, режимы наблюдения). Кроме того, требуется разработка эффективных методов оценки патоморфологического ответа.
Об авторе
Е. Х. Сейнароева
ФГАОУ ВО «Первый Московский государственный медицинский университет им. И. М. Сеченова» Минздрава России (Сеченовский Университет)
Россия
Конфликт интересов:
Россия
Ева Хасановна Сейнароева
119991 Москва, ул. Трубецкая, 8, стр. 2
Конфликт интересов:
Автор заявляет об отсутствии конфликта интересов.
Список литературы
1. Bray F., Laversanne M., Sung H., et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2024;74(3):229–263. https://doi.org/10.3322/caac.21834
2. Forde P.M., Spicer J., Lu S., et al. CheckMate 816 Investigators. Neoadjuvant nivolumab plus chemotherapy in resectable lung cancer. N Engl J Med 2022;386(21):1973–1985. https://doi.org/10.1056/NEJMoa2202170
3. Provencio M., Nadal E., Insa A., et al. Neoadjuvant chemotherapy and nivolumab in resectable non-small-cell lung cancer (NADIM): an open-label, multicentre, single-arm, phase 2 trial. Lancet Oncol 2020;21(11):1413–1422. https://doi.org/10.1016/S1470-2045(20)30453-8
4. Wakelee H., Liberman M., Kato T., et al. KEYNOTE-671 investigators. Perioperative pembrolizumab for early-stage non-small-cell lung cancer. N Engl J Med. 2023 Aug 10;389(6):491–503. https://doi.org/10.1056/NEJMoa2302983
5. Кононец П.В. Торакоскопическая пневмонэктомия при раке. Клин. и эксперимент. хир. Журн. им. акад. Б. В. Петровского 2017;2:6–12.
6. Пикин О.В., Рябов А.Б., Трахтенберг А.Х., и др. Анализ послеоперационных осложнений по системе ТММ у больных немелкоклеточным раком легкого после пневмонэктомии за 5-летний период. Хирургия. Журнал им. Н.И. Пирогова 2016;1:23–27. https://doi.org/10.17116/hirurgia20161223-27.
7. Jones G.D., Caso R., Tan K.S., et al. Propensity-matched analysis demonstrates long-term risk of respiratory and cardiac mortality after pneumonectomy compared with lobectomy for lung cancer. Ann Surg 2022;275(4):793–799. https://doi.org/10.1097/SLA.0000000000004065
8. Habr-Gama A., Perez R.O., Nadalin W., et al. Operative versus nonoperative treatment for stage 0 distal rectal cancer following chemoradiation therapy: long-term results. Ann Surg 2004;240(4):711–7; discussion 717–8. https://doi.org/10.1097/01.sla.0000141194.27992.32
9. Habr-Gama A., de Souza P.M., Ribeiro U.Jr., et al. Low rectal cancer: impact of radiation and chemotherapy on surgical treatment. Dis Colon Rectum 1998;41(9):1087–96. https://doi.org/10.1007/BF02239429
10. Marinelli D., Nuccio A., Di Federico A., et al. Improved event-free survival after complete or major pathologic response in patients with resectable nsclc treated with neoadjuvant chemoimmunotherapy regardless of adjuvant treatment: a systematic review and individual patient data meta-analysis. J Thorac Oncol 2025;20(3):285–295. https://doi.org/10.1016/j.jtho.2024.09.1443
11. Reijers I.L.M., Menzies A.M., Lopez-Yurda M., et al. Impact of personalized response-directed surgery and adjuvant therapy on survival after neoadjuvant immunotherapy in stage III melanoma: Comparison of 3-year data from PRADO and OpACIN-neo. Eur J Cancer 2025;214:115141. https://doi.org/10.1016/j.ejca.2024.115141
12. Forde P.M., Spicer J., Lu S., et al. CheckMate 816 Investigators. Neoadjuvant nivolumab plus chemotherapy in resectable lung cancer. N Engl J Med 2022;386(21):1973–1985. https://doi.org/10.1056/NEJMoa2202170
13. Zhang Z., Lin Y., Chen S. Efficacy of neoadjuvant, adjuvant, and perioperative immunotherapy in non-small cell lung cancer across different PD-L1 expression levels: a systematic review and meta-analysis. Front Immunol 2025;16:1569864. https://doi.org/10.3389/fimmu.2025.1569864
14. Meng Y., Han H., Zhu S., et al. Identifying patients who benefit more from perioperative immunotherapy combinations for resectable non-small cell lung cancer based on clinical and molecular characteristics: a meta-analysis of randomized clinical trials. Clin Transl Oncol 2025;27(4):1516–1528. https://doi.org/10.1007/s12094-024-03712-0
15. Calles A., Riess J.W., Brahmer J.R. Checkpoint blockade in lung cancer with driver mutation: choose the road wisely. Am Soc Clin Oncol Educ Book 2020;40:372–384. https://doi.org/10.1200/EDBK_280795
16. Bylicki O., Paleiron N., Margery J., et al. Targeting the PD-1/PD-L1 immune checkpoint in EGFR-mutated or ALK-translocated non-small-cell lung cancer. Target Oncol 2017;12(5):563–569. https://doi.org/10.1007/s11523-017-0510-9
17. Eisenhauer E.A., Therasse P., Bogaerts J., et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 2009;45(2):228–47. https://doi.org/10.1016/j.ejca.2008.10.026
18. Chen D.S., Mellman I. Elements of cancer immunity and the cancer-immune set point. Nature 2017;541(7637):321–330. https://doi.org/10.1038/nature21349 19. Chiou V.L., Burotto M. Pseudoprogression and immune-related response in solid tumors. J Clin Oncol 2015;33(31):3541–3. https://doi.org/10.1200/JCO.2015.61.6870
19. Ferrara R., Mezquita L., Texier M., et al. Hyperprogressive disease in patients with advanced non-small cell lung cancer treated with PD-1/PD-L1 inhibitors or with single-agent chemotherapy. JAMA Oncol 2018;4(11):1543–1552. https://doi.org/10.1001/jamaoncol.2018.3676
20. Nelles C., Gräf M., Bernard P., et al. Real-world response assessment of immune checkpoint inhibition: comparing iRECIST and RECIST 1.1 in melanoma and non-small cell lung cancer patients. Eur Radiol 2025;35(4):2084–2093. https://doi.org/10.1007/s00330-024-11060-4
21. Lopci E., Toschi L., Grizzi F., et al. Correlation of metabolic information on FDG-PET with tissue expression of immune markers in patients with non-small cell lung cancer (NSCLC) who are candidates for upfront surgery. Eur J Nucl Med Mol Imaging 2016;43(11):1954–61. https://doi.org/10.1007/s00259-016-3425-2
22. Chen Z.Y., Fu R., Tan X.Y., et al. Dynamic 18 F-FDG PET/CT can predict the major pathological response to neoadjuvant immunotherapy in non-small cell lung cancer. Thorac Cancer 2022;13(17):2524–2531. https://doi.org/10.1111/1759-7714.14562
23. Zhang C., Liu J., Tong J., et al. 18F-FDG-PET evaluation of pathological tumour response to neoadjuvant therapy in patients with NSCLC. Nucl Med Commun 2013;34(1):71–7. https://doi.org/10.1097/MNM.0b013e3283599999
24. Castello A., Rossi S., Lopci E. 18F-FDG PET/CT in restaging and evaluation of response to therapy in lung cancer: state of the art. Curr Radiopharm 2020;13(3):228–237. https://doi.org/10.2174/1874471013666191230144821
25. Orr L., Krochmal R., Sonti R., et al. Comparison of the GenCut core biopsy system to transbronchial biopsy forceps for flexible bronchoscopic lung biopsy. J Bronchology Interv Pulmonol 2022;29(2):140–145. https://doi.org/10.1097/LBR.0000000000000803
26. Sethi J., Ali M.S., Mohananey D., et al. Are transbronchial cryobiopsies ready for prime time?: a systematic review and meta-analysis. J Bronchology Interv Pulmonol 2019;26(1):22–32. https://doi.org/10.1097/LBR.0000000000000519
27. Sano M., Oki M. Transthoracic lung biopsy: diagnostic accuracy and complications. Transl Cancer Res 2023;12(2):233– 235. https://doi.org/10.21037/tcr-22-2703
28. Sasani M.R., Paknahad M. Complications of CT-guided percutaneous lung biopsy: a 1-year single-center experience in Iran. Med J Islam Repub Iran 2025;39:102. https://doi.org/10.47176/mjiri.39.102
29. Bartolomucci A., Nobrega M., Ferrier T., et al. Circulating tumor DNA to monitor treatment response in solid tumors and advance precision oncology. NPJ Precis Oncol 2025;9(1):84. https://doi.org/10.1038/s41698-025-00876-y
30. Pellini B., Chaudhuri A.A. Circulating tumor DNA minimal residual disease detection of non-small-cell lung cancer treated with curative intent. J Clin Oncol 2022;40(6):567–575. https://doi.org/10.1200/JCO.21.01929
31. Cascone T., Awad M.M., Spicer J.D., et al. CheckMate 77T investigators. Perioperative nivolumab in resectable lung cancer. N Engl J Med 2024;390(19):1756–1769. https://doi.org/10.1056/NEJMoa2311926
32. Forde P.M., Spicer J., Lu S. Provencio, M., et al. CheckMate 816 Investigators. Neoadjuvant nivolumab plus chemotherapy in resectable lung cancer. N Engl J Med 2022;386(21):1973–1985. https://doi.org/10.1056/NEJMoa2202170
33. Chen K., Zhao H., Shi Y., et al. Perioperative dynamic changes in circulating tumor DNA in patients with lung cancer (DYNAMIC). Clin Cancer Res 2019;25(23):7058–7067. https://doi.org/10.1158/1078-0432.CCR-19-1213
34. Abbosh C., Frankell A., Garnett A., et al. Phylogenetic tracking and minimal residual disease detection using ctDNA in early-stage NSCLC: A lung TRACERx study. AACR Annual Meeting 2020;80 (16_Supplement):CT023-CT023. https://doi.org/10.1158/1538-7445.AM2020-CT023
35. Reck M., Gale D., Harpole D, et al. LBA59 Associations of ctDNA clearance and pathological response with neoadjuvant treatment in patients with resectable NSCLC from the phase III AEGEAN trial. Ann Oncol 2023;34:S1300. https://doi.org/10.1016/j.annonc.2023.10.055
36. Liu T., Zhang W., Liu C., et al. Efficacy of endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of mediastinal and hilar lesions. Curr Med Imaging 2024;20. https://doi.org/10.2174/1573405620666230428121243
37. Chrysikos S., Karampitsakos T., Zervas E., et al. Thoracic endosonography (EBUS/EUS-b) in the diagnosis of different intrathoracic diseases: A 4-year experience at a single-centre in Greece. Int J Clin Pract 2021;75(3):e13684. https://doi.org/10.1111/ijcp.13684
38. Hong G., Oki M. Transesophageal endoscopic ultrasound with bronchoscope-guided fine-needle aspiration for diagnostic and staging purposes: a narrative review. J Thorac Dis 2023;15(9):5088–5098. https://doi.org/10.21037/jtd-23-681
39. Vilmann P., Clementsen P.F., Colella S., et al. Combined endobronchial and esophageal endosonography for the diagnosis and staging of lung cancer: European Society of Gastrointestinal Endoscopy (ESGE) Guideline, in cooperation with the European Respiratory Society (ERS) and the European Society of Thoracic Surgeons (ESTS). Endoscopy 2015;47(6):545–59. https://doi.org/10.1055/s-0034–1392040. Erratum in: Endoscopy 2015;47(6):c1. https://doi.org/10.1055/s-0034-1392453
40. Erasmus L.T., Strange T.A., Agrawal R., et al. Lung cancer staging: imaging and potential pitfalls. Diagnostics (Basel) 2023;13(21):3359. https://doi.org/10.3390/diagnostics13213359
41. Kremer R., Peysakhovich Y., Dan L.F., et al. FDG PET/CT for assessing the resectability of NSCLC patients with N2 disease after neoadjuvant therapy. Ann Nucl Med 2016;30(2):114–21. https://doi.org/10.1007/s12149-015-1038-7
42. Liu X., Duan B., Liu R., et al. Enhancing clinical complete response assessment in rectal cancer: integrating transanal multipoint full-layer puncture biopsy criteria: a systematic review. Front Oncol 2024;14:1428583. https://doi.org/10.3389/fonc.2024.1428583
43. Gu C., Teng X., Sun X., et al. Impact of treatment interval between neoadjuvant immunochemotherapy and surgery in lung squamous cell carcinoma. BMC Cancer 2024;24(1):585. https://doi.org/10.1186/s12885-024-12333-3
44. Chen J., Deng H., He J., et al. Impact of the interval between neoadjuvant immunochemotherapy and surgery on surgical-pathological outcomes in non-small cell lung cancer. Front Oncol 2022;12:909726. https://doi.org/10.3389/fonc.2022.909726
45. Lococo F., Sassorossi C., Nachira D., et al. Prognostic factors and long-term survival in locally advanced NSCLC with pathological complete response after surgical resection following neoadjuvant therapy. Cancers (Basel) 2020;12(12):3572. https://doi.org/10.3390/cancers12123572
46. İşgörücü Ö., Citak N. Survival analysis of pathological complete response of locally advanced lung cancer after neoadjuvant treatment. Gen Thorac Cardiovasc Surg 2021;69(7):1086–1095. https://doi.org/10.1007/s11748-020-01584-z
47. McMurry T.L., Stukenborg G.J., Kessler L.G., et al. More frequent surveillance following lung cancer resection is not associated with improved survival: a nationally representative cohort study. Ann Surg 2018;268(4):632–639. https://doi.org/10.1097/SLA.0000000000002955
48. Bodor J.N., Feliciano J.L., Edelman M.J. Outcomes of patients with disease recurrence after treatment for locally advanced non-small cell lung cancer detected by routine follow-up CT scans versus a symptom driven evaluation. Lung Cancer 2019;135:16–20. https://doi.org/10.1016/j.lungcan.2019.07.009. Erratum in: Lung Cancer 2019;136:157. https://doi.org/10.1016/j.lungcan.2019.08.015
49. Schneider B.J., Ismaila N., Aerts J., et al. Lung cancer surveillance after definitive curative-intent therapy: ASCO guideline. J Clin Oncol 2020;38(7):753–766. https://doi.org/10.1200/JCO.19.02748
50. Федянин М.Ю., Гладков О.А., Гордеев С.С. и соавт. Рак ободочной кишки, ректосигмоидного соединения и прямой кишки. Клинические рекомендации RUSSCO, часть 1.1. Злокачественные опухоли 2025;15(3s2):310–372. https://doi.org/10.18027/2224-5057-2025-15-3s2-1.1-14.
51. Bar J., Maiocco G.D., Parikh K., et al. Real world characteristics of stages II-III NSCLC patients (pts) who initiate neoadjuvant chemo-immunotherapy (NACT-I) and do not undergo surgical resection. Clin Oncol 2025;43(8019):16_suppl. https://doi.org/10.1200/JCO.2025.43.16_suppl.8019
52. Lococo F., Sassorossi C., Nachira D., et al. Prognostic factors and long-term survival in locally advanced NSCLC with pathological complete response after surgical resection following neoadjuvant therapy. Cancers (Basel) 2020;12(12):3572. https://doi.org/10.3390/cancers12123572
53. Kayawake H., Okumura N., Yamanashi K., et al. Non-small cell lung cancer with pathological complete response: predictive factors and surgical outcomes. Gen Thorac Cardiovasc Surg 2019;67(9):773–781. https://doi.org/10.1007/s11748-019-01076-9
54. Chicas-Sett R., Zafra .J, Rodriguez-Abreu D., et al. Combination of SABR with Anti-PD-1 in oligoprogressive nonsmall cell lung cancer and melanoma: results of a prospective multicenter observational study. Int J Radiat Oncol Biol Phys 2022;114(4):655–665. https://doi.org/10.1016/j.ijrobp.2022.05.013
55. Schreiner W., Dudek W., Lettmaier S., et al. Should salvage surgery be considered for local recurrence after definitive chemoradiation in locally advanced non-small cell lung cancer? J Cardiothorac Surg 2016;11:9. https://doi.org/10.1186/s13019-016-0396-0.
Рецензия
Для цитирования:
Сейнароева Е.Х. Возможность применения тактики “watch and wait” в терапии пациентов с немелкоклеточным раком легкого (обзорная статья). Malignant tumours. 2026;16(1):98–107. https://doi.org/10.18027/2224-5057-2026-075
For citation:
Seynaroeva E.H. The possibility of using “watch and wait” approach in the treatment of patients with non-small cell lung cancer (literature review). Malignant tumours. 2026;16(1):98–107. (In Russ.) https://doi.org/10.18027/2224-5057-2026-075
Просмотров:
166
JATS XML
Послать статью по эл. почте 