摘要：由国际肺癌研究协会（IASLC）主办的2025年世界肺癌大会（WCLC2025）于2025年9月9日在西班牙巴塞罗那圆满闭幕。作为肺癌及其他胸部恶性肿瘤领域全球领先的多学科肿瘤学盛会，本次大会吸引了来自世界各地的众多专家学者参会，围绕肺癌及其他胸部恶性肿瘤的前
由国际肺癌研究协会（IASLC）主办的2025年世界肺癌大会（WCLC2025）于2025年9月9日在西班牙巴塞罗那圆满闭幕。作为肺癌及其他胸部恶性肿瘤领域全球领先的多学科肿瘤学盛会，本次大会吸引了来自世界各地的众多专家学者参会，围绕肺癌及其他胸部恶性肿瘤的前沿诊疗进展展开了深入探讨。
大会特设“Highlights of the Day”专场，旨在回顾当日领域重磅研究进展，为全球肺癌领域研究者提供了聚焦当日核心进展的高效途径，以便快速捕捉研究动态、同步前沿认知。在会议现场，《肿瘤瞭望》特邀“免疫治疗”领域“Highlights of the Day”专场汇报者罗马Regina Elena国家癌症研究所Federico Cappuzzo教授接受专访，回顾WCLC免疫治疗领域重磅研究进展，特此整理，以飨读者。
专家简介
Federico Cappuzzo 教授
罗马Regina Elena国家癌症研究所肿瘤内科主任
意大利肿瘤内科学会（AIOM）、欧洲肿瘤内科学会（ESMO）、美国临床肿瘤学会（ASCO）、国际肺癌研究协会（IASLC）会员
曾任国际肺癌研究协会（IASLC）教育委员会主席
《Lung Cancer》杂志编辑委员会成员
肿瘤瞭望：您在Highlights of the Day - Sunday Abstracts环节中，分享了转移性非小细胞肺癌免疫治疗研究亮点内容，请您为我们介绍下相关亮点有哪些？
Federico Cappuzzo教授：我主要展示了四项相关研究成果：第一项试验为ASTRUM-002研究（摘要号：OA05.01），旨在评估斯鲁利单抗联合 HLX04（贝伐珠单抗生物类似药）与化疗（培美曲塞联合卡铂）的方案，相较于斯鲁利单抗联合化疗的方案，在非鳞非小细胞肺癌（NSCLC）治疗中的疗效。该研究结果表明，在化疗联合免疫治疗基础上添加抗血管生成药物相较于免疫联合化疗方案，其无进展生存期（PFS）并无显著获益优势。
第二项试验为ZEAL-1L研究（摘要号：OA05.04），评估了PARP抑制剂尼拉帕利联合帕博利珠单抗用于晚期/转移性非小细胞肺癌维持治疗安全性及有效性，结果显示，尼拉帕利未能改善盲审评估的PFS，关键次要终点亦未见获益。安全性与已知特征一致，个别患者出现药物相关死亡事件。这一阴性结果提示，尽管这一方案有临床前数据支持，但试验中未观察到获益证据；此外，在总生存期方面，我们无法排除该治疗可能存在的安全性影响。
第三项试验针对脑转移患者——NIVIPI-Brain研究（摘要号：OA05.03），评估了纳武利尤单抗（Nivolumab）、伊匹木单抗（Ipilimumab）联合化疗用于合并同步脑转移的非小细胞肺癌患者的疗效。该试验同样未达到主要终点——研究预设的主要终点 “6个月颅内PFS率” 未实现。
第四项试验为IFCT-1805 Elderly研究（摘要号：OA05.02），法国研究者评估了一线阿替利珠单抗（Atezolizumab）联合化疗在晚期非小细胞肺癌老年患者中的疗效，这类患者在日常临床实践中占比很高。该研究也未达到总生存期这一主要终点，但包括缓解率、无进展生存期、疾病控制率在内的所有其他终点，均显示添加免疫治疗具有优势，以上便是免疫治疗相关主要最新进展。
Professor Federico Cappuzzo：I just recapitulated the data that were presented yesterday at this meeting—specifically the data on immunotherapy. I displayed data from four different clinical trials.
The first trial considered the addition of an Anti-angiogenic agent to chemo-immunotherapy. This trial was completely negative, showing no benefit from the addition of a biosimilar of bevacizumab to chemo-immunotherapy.
The second trial explored the role of PARP inhibitors in combination with immunotherapy, again in patients with metastatic non-small cell lung cancer. Although this approach is supported by preclinical data, no evidence of benefit was observed in the trial. Moreover, in terms of overall survival, we cannot exclude a detrimental effect of this treatment.
The third trial was in patients with brain metastases, it evaluated the efficacy of Nivolumab、Ipilimumab combined with chemotherapy in NSCLC With synchronous Brain metastases. Again, this trial did not meet its primary endpoint—the 6-month disease control rate, which was the primary endpoint of this study, was not achieved. Finally, French investigators evaluated the aefficacy of first-line Atezolizumab plus chemotherapy in elderly patients with advanced NSCLC—a group of patients very well represented in our daily clinical practice. This study also did not meet its primary endpoint of overall survival. However, all other endpoints—response rate, progression-free survival, and disease control rate—were certainly in favor of the addition of immunotherapy. So that was probably the main update presented yesterday regarding immunotherapy.
肿瘤瞭望：您在本次世界肺癌大会（WCLC）上公布的 IMscin002 研究最终分析显示，超过 77% 的患者在同时接受过皮下注射和静脉注射阿替利珠单抗后，后续治疗选择了皮下注射方式。您认为这种给药途径的转变，会对治疗疗效、安全性、患者生活质量及治疗依从性产生哪些深远影响？这是否有望重新定义未来免疫治疗的应用模式？
Federico Cappuzzo教授：IMscin002试验探索了阿替利珠单抗皮下注射的可行性。研究中让患者在皮下注射和静脉注射之间选择偏好方式，结果明确显示患者更倾向于皮下注射。此外，这种给药方式能为患者带来诸多优势，尤其是在减少门诊就诊时间方面；同时对医院而言，也能优化药物制备的流程时间。因此，这一方式可能对所有相关人员都十分便捷。本次大会上公布的是该研究的更新结果，通过更长时间的随访证实，所有预设终点均已达到。
Professor Federico Cappuzzo：The IMscin002 trial explored the possibility of administering atezolizumab subcutaneously. Patients indicated their preference between subcutaneous and intravenous injection, and the trial clearly showed that patient preference is in favor of subcutaneous use—that is important to remember. Additionally, this approach offers many advantages for patients, particularly in terms of the time they have to spend in the clinic, as well as for hospitals in terms of organizational timing for drug preparation. So this is an approach that is really convenient for everyone, probably. That is the major message. What was presented at this meeting is an update of these results, confirming with longer follow-up that, in fact, all these endpoints were met.
肿瘤瞭望：结合相关研究进展，您如何看待免疫治疗联合抗体药物偶联物（ADCs）在晚期非小细胞肺癌中的应用潜力与挑战？
Federico Cappuzzo教授：我认为ADCs联合免疫治疗是一种极具潜力的方案。我们需要大型临床试验数据来明确这类药物的作用定位。目前已有部分数据显示该方案具有潜在疗效，我们期望ADCs能优于标准化疗。同时我们也清楚，当前需要关注这种联合方案可能产生的毒性反应。
Professor Federico Cappuzzo：I think the combination of ADCs and immunotherapy is a very promising approach. We need data from large clinical trials to clearly understand the role of these agents. Currently, we have some data showing the potential efficacy of this approach. What we hope is that ADCs could be superior to standard chemotherapy. We also know that, at present, we need to pay attention to the toxicity that may result from this combination.
肿瘤瞭望：本次大会还设有“特殊人群免疫治疗”专场，分享相关研究进展。基于大会公布的研究成果，哪项研究结果给您留下的印象最为深刻？这些研究是否在患者筛选、治疗方案设计或疗效 / 安全性数据方面，突破了现有的治疗格局？
Federico Cappuzzo教授：目前尚不能说有研究真正改变了临床实践标准，但本次大会公布的多项研究均具有重要意义。在我看来，FLAURA-2 试验的生存数据尤为关键，该研究显示，EGFR突变型非小细胞肺癌患者在奥希替尼（osimertinib）治疗基础上联合化疗，可获得生存获益。这一结果意义重大，因为它可能在一定程度上影响临床实践，尤其是医生和患者对一线治疗方案的选择偏好。另一项重要数据与依沃西单抗（Ivonescimab）相关，HARMONi研究评估了该双特异性抗体联合化疗用于铂类耐药患者的疗效，结果十分具有参考价值。对于这类患者群体而言，这无疑有望成为新的治疗选择之一。
Professor Federico Cappuzzo：I cannot say that we have studies that truly change the standard of practice, but we do have important studies that were presented today. In my opinion, the survival data from the FLAURA-2 trial are very relevant, as they show a survival benefit from the addition of chemotherapy to osimertinib in EGFR-mutant non-small cell lung cancer. This is very important because it could, in some way, impact clinical practice—specifically doctor and patient preferences for frontline treatment. The other important data are about Ivonescimab (anti-PD-1/anti-vascular endothelial growth factor). The data presented yesterday—evaluating this bispecific antibody together with chemotherapy in platinum-resistant patients—are very interesting. This is certainly one of the new options that we can probably offer to this group of patients.
肿瘤瞭望：结合本次世界肺癌大会的多项研究成果，您认为当前在晚期或转移性非小细胞肺癌临床实践中，免疫治疗仍面临哪些挑战？未来的突破方向是什么？
Federico Cappuzzo教授：最重要的一点是，尽管免疫治疗已彻底改变非小细胞肺癌的治疗模式，但遗憾的是，仍有相当比例的患者会出现疾病复发或对治疗不敏感（即存在免疫治疗原发性耐药）。因此，真正的挑战在于：提高对免疫治疗敏感的患者比例，同时降低短期缓解者（即便是治疗有效，但缓解持续时间较短的患者）的比例。基于此，我们亟需优化治疗策略，无论是采用联合治疗方案，还是研发新型免疫治疗药物，最终目标都是提高长期存活患者的比例。
Professor Federico Cappuzzo：The most important point is that, even though immunotherapy is completely changing the treatment of non-small cell lung cancer, unfortunately, we still have a significant proportion of patients who relapse or insensitive, i.e., have primary resistance to immunotherapy. So the real challenge is to increase the percentage of patients sensitive to immunotherapy and to reduce the percentage of short-term responders (patients in whom, even if we achieve a response, the duration of response is short). Therefore, we certainly need to improve strategies—using combinations or new immunotherapeutic agents—with the endpoint of increasing the percentage of long-term survivors.
来源：肿瘤瞭望
