肺癌是美国和世界癌症死亡的主要原因。它分为两种主要类型：小细胞肺癌（SCLC）和非小细胞肺癌（NSCLC）。在肿瘤-淋巴结-转移 (TNM) 癌症分期分类系统（I/II/III/IV 期）中，肿瘤生长的严重程度由肿瘤的大小（T1 至 T4）、淋巴结的范围来表征受累情况（N0 至 N3），以及是否发生（M1）或（M0）远处转移。手术是健康状况良好的 I/II 期 NSCLC 患者的首选治疗方法。放化疗和免疫检查点抑制剂联合治疗适用于所有非小细胞肺癌类型。具有致敏 EGFR 或 BRAF 突变或激活 ALK、ROS1 或 NTRK 易位的癌基因成瘾性肿瘤可使用其同源口服活性小分子蛋白激酶阻滞剂进行治疗。大约 20% 的 NSCLC 带有 EGFR 激活突变，并接受奥希替尼和其他激酶拮抗剂治疗。 SCLC 约占肺癌病例的 15%，是一种致命的高级别神经内分泌癌，预后较差。局限期 SCLC 局限于一侧胸部和 1 个放射端口，广泛期疾病表示那些不符合有限期疾病标准的癌症。控制胸部疾病的局部治疗选择包括放射治疗和手术。对于广泛期疾病患者，推荐的一线方案是铂类药物（顺铂或卡铂）联合依托泊苷和抗 PDL1 抑制剂（atezolizumab 或 durvalumab）四个周期，然后进行抗 PDL1 维持治疗。版权所有 © 2024 作者。由爱思唯尔有限公司出版。保留所有权利。

Lung cancer is the leading cause of cancer deaths in the United States and the world. It is divided into two major types: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). In the tumor-node-metastasis (TNM) cancer-staging classification system (Stages I/II/III/IV), the severity of neoplastic growth is characterized by the size of the tumor (T1 to T4), the extent of lymph node involvement (N0 to N3), and whether (M1) or not (M0) distant metastasis has occurred. Surgery is the treatment of choice for medically fit patients with Stage I/II NSCLC. Combination chemoradiotherapy and immune checkpoint inhibitor therapy are used across all NSCLC types. Oncogene-addicted tumors with sensitizing EGFR or BRAF mutations or activating ALK, ROS1 or NTRK translocations are treated with their cognate orally active small molecule protein kinase blockers. On the order of 20% of NSCLCs bear activating mutations in EGFR and are treated with osimertinib and other kinase antagonists. SCLC, which accounts for approximately 15% of lung cancer cases, is a deadly high-grade neuroendocrine carcinoma with a poor prognosis. Limited-stage SCLC is confined to one hemi-thorax and one radiation port and extensive-stage disease signifies those cancers that do not meet the criteria for limited-stage disease. Local treatment options to control thoracic disease include radiotherapy and surgery. In patients with extensive-stage disease, a platinum agent (cisplatin or carboplatin) combined with etoposide and an anti-PDL1 inhibitor (atezolizumab or durvalumab) for four cycles followed by anti-PDL1 maintenance therapy is the recommended first-line regimen.Copyright © 2024 The Author. Published by Elsevier Ltd.. All rights reserved.