
2026-04-09
Unyango oluqhubekayo lomhlaza wemiphunga ngo-2026 lujolise kubuchule bomntu kusetyenziswa izikhokelo ze-NCCN zamva nje, uvavanyo oluphambili lwe-biomarker, kunye nonyango lwenoveli efana ne-antibody-drug conjugates (ADCs) kunye nezithinteli-gazi ezizimbini. Kwizigulane ezifumana ukubuya kwesifo, ukhetho ngoku lubandakanya ukuphinda umngeni kunye nee-agent zangaphambili, ukutshintshela kwiindlela ezintsha zonyango ezijoliswe kuzo ezisekelwe kwiindlela zokuchasa, okanye ukubhalisa kwizilingo zeklinikhi ze-immunotherapies ezivelayo.
Ukuphindaphinda komhlaza wemiphunga kwenzeka xa isifo sibuya emva konyango lokuqala, mhlawumbi ekuhlaleni, kwingingqi, okanye kude. Ngo-2026, indlela yoku unyango lomhlaza wemiphunga oluphindaphindiweyo itshintshe kakhulu ukusuka kwimodeli yobukhulu obunye ukuya kwiyeza elichanekileyo eliqhutywa yiprofayili yemolekyuli.
Inkcazo yokuphindaphinda ixhomekeke kwixesha elidlulileyo ukususela kunyango oluphambili. Ukuphindaphinda kwangethuba kudla ngokucebisa isifo esinganyangekiyo, ngelixa ukuphinda kuvele kade kunokubonisa ithumba elitsha eliphambili okanye iiseli ezileleyo ziphinde zisebenze. Iiprothokholi zangoku zigxininisa ukwahlula phakathi kwezi meko ukukhokela ukhetho lonyango ngempumelelo.
Izixhobo zanamhlanje zokuxilonga ngoku zivumela oogqirha ukuba babone isifo esishiyekileyo esincinci kwangoko kunangaphambili. Le festile yokufumanisa kwangaphambili inika ithuba elibalulekileyo lokungenelela ngaphambi kokuba umthwalo we-tumor ungalawuleki, uphucula kakhulu iziphumo zesigulane.
Ukuphindaphinda kuhlelwe ngokweendidi ezintathu eziphambili: indawo, ingingqi, kunye nekude. Ukuphindaphinda kwendawo kwenzeka kwindawo yokuqala yethumba, ngelixa ukuphindaphinda kwengingqi kubandakanya i-lymph nodes ezikufutshane. Ukuphindaphinda okude, okanye i-metastasis, ichaphazela amalungu afana nengqondo, amathambo, okanye isibindi.
Ukuqonda indlela yokuphindaphinda kubalulekile. Ngokomzekelo, isifo se-oligometastatic (ukusasazeka okulinganiselweyo) sisenokuba luncedo kunyango lwendawo olunobundlobongela njengonyango lweradiation ye-stereotactic body radiation (SBRT), enika ulawulo olunokubakho lwexesha elide.
Izikhokelo ze-2026 ze-NCCN zeClinical Practice for Non-Small Cell Lung Cancer (NSCLC) zizisa uhlaziyo olubalulekileyo olufanelekileyo kwizifo eziphindaphindiweyo. Utshintsho olukhulu kukwamkelwa jikelele kwenkqubo yeqonga ye-AJCC yoHlelo lwe-9th ye-TNM, iqinisekisa ukuhlelwa okuchanekileyo kunye novavanyo lweprognostic.
Kwiimeko eziphindaphindiweyo, izikhokelo zigxininisa imfuneko yokuphinda uvavanyo lwe-biomarker. Amathumba anokuvela, afumane utshintsho olutsha olunika unyango lwangaphambili lungasebenzi. Ke ngoko, i-re-biopsy okanye i-liquid biopsy ngoku isisenzo esiqhelekileyo sokuchonga iithagethi ezinokuthathwa.
Iindlela zokuxilonga nazo zilungisiwe. Izigulana ezisemngciphekweni omkhulu zicetyiswa ukuba zenze umfanekiso wokucupha rhoqo emva kweenyanga ezili-12 ukuze ziqaphele ukuqhubela phambili okuncinci kwangethuba. Oku kubeka iliso okusebenzayo kunceda kungenelelo olungexesha, ukuthintela ukusasazwa okubanzi.
Izikhokelo zika-2026 zigxininisa imigaqo ethile yonyango olujoliswe kwi-biomarker kwiisethingi eziphambili okanye ze-metastatic. Olunye uhlaziyo oluphawulekayo lubandakanya ulawulo lwe-Amivantamab. Ukuqulunqwa kwe-subcutaneous kunye ne-hyaluronidase ngoku kuyindlela eyamkelweyo yokuhanjiswa kwe-intravenous, enikezela lula ngaphandle kokuphazamisa ukusebenza kakuhle.
Olu tshintsho lubonisa umkhwa obanzi wokhathalelo lwesigulane, ukunciphisa ukutyelelwa kwezibhedlele kunye namaxesha okuxilwa. Nangona kunjalo, imiyalelo ye-dosing iyahluka phakathi kwemixube, efuna ingqwalasela ebukhali evela kubaboneleli bezempilo ukuqinisekisa ukhuseleko kunye nokusebenza.
Ngaphezu koko, izikhokelo zincoma iprofayili ebanzi ye-genomic kuzo zonke izigulane ezinezifo eziphindaphindiweyo, kungakhathaliseki ukuba yimbali yovavanyo lwangaphambili. Oku kuqinisekisa ukuba akukho njongo zivelayo ziphosakele, ezifana nokuguqulwa kwe-HER2 okanye ukwahluka kwe-KRAS G12C, ezinokhetho olutsha olukhoyo lonyango.
Imbonakalo yomhlaba ye unyango lomhlaza wemiphunga oluphindaphindiweyo iye yatshintshwa lunyango olunempumelelo oluye lwaqaliswa okanye lwaqinisekiswa ekuqaleni kuka-2026. Olu tshintsho lunika ithemba kwizigulana eziqhubele phambili kunyango olusemgangathweni.
Ii-antibody-drug conjugates (ADCs) ziye zavela njengelitye lembombo ekunyangeni amatyala aphikisayo. Iiarhente ezijolise kwi-TROP2 kunye ne-HER2 zibonise ukusebenza okuphawulekayo kwizigulane ezineenguqu ze-EGFR eziye zagqiba i-tyrosine kinase inhibitors (TKIs).
Ukongeza, ii-antibodies ze-bispecific ziyakhula. Ezi molekyuli zibandakanya iithagethi ezimbini ezahlukeneyo ngaxeshanye, ukuphucula ukuphendula komzimba kunye nokuthintela iindlela ezininzi zokukhula. Idatha yakutsha nje icebisa ukuba banokuloyisa iindlela zokuxhathisa ezinciphisa unyango lwe-arhente enye.
Ii-ADCs zidibanisa i-monoclonal antibody kunye ne-cytotoxic payload, ihambisa ichemotherapy ngqo kwiiseli zomhlaza ngelixa igcina izicubu eziphilileyo. Ngo-2026, amachiza afana neTrastuzumab Deruxtecan kunye neDatopotamab Deruxtecan abalulekile kwi-NSCLC ephindaphindiweyo.
Ulingo lwezonyango, olufana ne-OptiTROP-Lung03, lubonise ukuba ii-ADCs zinokuphucula kakhulu ukusinda xa kuthelekiswa nechemotherapy yesintu. Ngokomzekelo, izigulane ezine-EGFR-mutant NSCLC eziphathwayo zifumene ukusinda okupheleleyo kweenyanga ze-20 kunye nonyango oluthile lwe-ADC.
Umatshini ubandakanya ukubophelela kwi-antigens engaphezulu kwi-tumor cells, ukufakwa ngaphakathi, kunye nokukhululwa komthwalo oyityhefu. Le ndlela ekujoliswe kuyo inciphisa iziphumo ebezingalindelekanga zenkqubo, iyenze ilungele izigulana ezibuthathaka ezingakwaziyo ukunyamezela iirejimeni zechemotherapy eziqatha.
Izilwa-buhlungu ezingqale kabini zimele omnye umda. I-Pumitamig, i-PD-L1 kunye ne-VEGF-A ye-bispecific antibody, ibonise iziphumo ezithembisayo kwiSigaba 1b/2a solingo kunyango lokuqala lwe-PD-L1 positive NSCLC. Ukukwazi kwayo ukuvimba i-immune checkpoints kunye nokuthintela i-angiogenesis ngaxeshanye kudala indawo enamandla yokulwa ne-tumor.
Ngaphezu koko, i-immunotherapies entsha ivavanywa kwizigulane eziqhubela phambili kwi-PD-(L) ye-1 inhibitors ekhoyo. I-Gotistobart, okwangoku kwiSigaba sesi-3 solingo, ithelekisa ngokufanelekileyo ngokuchasene ne-docetaxel kwi-NSCLC ye-metastatic squamous, enikezela ngomgca omtsha wokuzikhusela kwabo banokhetho olulinganiselweyo.
Ezi arhente zisebenza ngokubandakanya ii-T-cells ngokusebenzayo ngakumbi okanye zijolise kwezinye iindlela zokuzikhusela. Ukwahluka kweendlela kuqinisekisa ukuba nangona enye indlela ivaliwe yi-tumor, abanye bahlala befikeleleka kungenelelo lonyango.
Umhlaza wemiphunga oguqukayo we-EGFR uzisa imiceli mngeni eyodwa xa uphinda uphinda-phinda, ngakumbi malunga neendlela zokuxhathisa. Inkomfa ye-ELCC ye-2026 igxininise idatha esisiseko ekulawuleni la matyala anzima, igxininisa izicwangciso zokudibanisa kunye nee-agent zesizukulwana esilandelayo.
Uphononongo lwe-TOP lubonise ukuba ukudibanisa i-Osimertinib kunye ne-chemotherapy kuphucula kakhulu ukusinda kwe-progression-free survival (PFS) kwizigulana ezineenguqu ze-TP53 ezihlangeneyo. Eli qela lingaphantsi lineziphumo ezibi kakhulu nge-TKI monotherapy, okwenza indibaniselwano itshintshe umdlalo.
Iziphumo zibonise i-PFS ephakathi kwiinyanga ze-34.0 zeqela elidibeneyo ngokubhekiselele kwiinyanga ze-15.6 ze-Osimertinib yodwa. Olu ncedo lukhulu lugxininisa ukubaluleka kokuchonga iiprofayili zemfuzo ezisemngciphekweni omkhulu kwangethuba kunye nokulungisa unyango ngokufanelekileyo.
Ngaphaya kwendibaniselwano yenkqubo, unyango lokumanyaniswa kwendawo (LCT) lubonakala luxabisekile. Uphononongo lwaseNorthStar lubonise ukuba ukongeza i-LCT (utyando okanye i-radiation) kwi-Osimertinib iphucula i-PFS kwi-metastatic EGFR-mutant NSCLC.
Izigulane ezifumana i-LCT zifumene i-PFS ephakathi kweenyanga ze-25.4 xa kuthelekiswa neenyanga ze-17.5 kunye ne-Osimertinib yodwa. Uphononongo lubonisa ukuba ukucoca isifo esisele kwi-thorax kunokulibazisa ukuqhubela phambili kwenkqubo, ngaphandle kokuba i-metastases ekude ilawulwa.
Iimpawu eziphambili zenzuzo ye-LCT ziquka ukucocwa kwe-pleural effusions kunye ne-mediastinal lymph nodes emva konyango lokungeniswa. Olu hlengahlengiso lunceda oogqirha ukuba bakhethe abagqatswa abanokuthi baxhamle kwindlela endlongondlongo yeendlela ezininzi.
Ukumelana ne-EGFR TKIs kaninzi kuvela ngotshintsho lwesibini olunje nge-C797S okanye iinguqu zephenotypic ezifana nomhlaza wemiphunga omncinci weseli (SCLC). Ukujongana nezi kufuna amacebo awohlukileyo.
Ukubeka iliso rhoqo kusetyenziswa i-biopsy engamanzi ivumela ukufunyaniswa kwexesha lokwenyani kolu tshintsho, okwenza uhlengahlengiso olukhawulezileyo lwesicwangciso sonyango ukugcina ulawulo lwezifo.
Umhlaza wamaLung weCell encinci (SCLC) yaziwa ngokuba ndlongondlongo kunye nezinga eliphezulu lokuphindaphinda. Izikhokelo ze-2026 ze-NCCN ze-SCLC zibonelela ngeengcebiso ezihlaziyiweyo zokulawula isifo esibuyele emva, kugxininise ekuphuculeni umgca wesibini kunye nonyango olulandelayo.
Kwizigulane ezibuyela umva ngaphezu kweenyanga ezintandathu emva konyango lokuqala, ukuphinda kucelwe umngeni kwirejimeni yoqobo esekwe kwiplatinam kudla ngokuqwalaselwa. Nangona kunjalo, kwabo babuyela ngokukhawuleza, ezinye ii-agent ziyimfuneko ukunqanda ukuxhathisa.
Ukuhlanganiswa kwe-immunotherapy kwisimo somgca wokuqala kuye kwatshintsha indawo yemigca elandelayo. Izigulane eziqhubela phambili emva kwe-chemo-immunotherapy zifuna iindlela ezintsha, kubandakanywa ii-agent ze-chemotherapeutic ezintsha kunye nonyango olujoliswe kuyo phantsi kophando.
I-Lurbinectedin izimise njengomdlali ophambili kwi-SCLC eqhubekayo, enikezela ngeprofayili yetyhefu ethandekayo kunye namazinga okuphendula anentsingiselo. Iluncedo kakhulu kwizigulana ezingakwaziyo ukunyamezela unyango olongezelelekileyo lweplatinam.
I-Topotecan ihlala iyindlela eqhelekileyo, ekhoyo kwiifom zombini zomlomo kunye ne-intravenous. Ngelixa isebenzayo, ukusetyenziswa kwayo ngamanye amaxesha kukhawulelwe yi-myelosuppression, ifuna ulawulo olululo lwedosi kunye nokhathalelo oluxhasayo.
Ulingo lwezonyango luya lubaluleka ngakumbi kwi-SCLC ngenxa yokuqina okulinganiselweyo kunyango lodidi lwesibini oluqhelekileyo. Amachiza ophando ajolise kwi-DLL3, anje nge-bispecific T-cell engagers, abonisa iziphumo ezichulumancisayo zokuqala kwaye anokuba yinxalenye ye-armamentarium eqhelekileyo.
I-Metastases yobuchopho yindawo eqhelekileyo yokuphindaphinda kwi-SCLC. Indima ye-prophylactic cranial irradiation (PCI) iphinda ihlolwe kwakhona kwixesha lokujongwa rhoqo kwe-MRI.
Iindlela zangoku zikhetha ukujongwa kwe-MRI ngokusondeleyo kwi-PCI yesiqhelo kwizigulana ezikhethiweyo ukunqanda ukwehla kwe-neurocognitive. Nangona kunjalo, kulabo abanesifo esibanzi okanye ukuthotyelwa kakubi ngokulandelelana, i-PCI ihlala iyindlela efanelekileyo yokukhusela inkqubo ye-nervous central.
Ukufunyaniswa kwangoko kweemetastases zobuchopho ngokucinga rhoqo kuvumela ungenelelo ngexesha elifanelekileyo kunye ne-stereotactic radiosurgery (SRS), ukugcina ukusebenza kwemithambo-luvo kunye nokwandisa ukusinda ngaphandle kweziphumo ebezingalindelekanga ezibanzi zokusasazeka kwemitha yengqondo epheleleyo.
Ukukhetha ekunene unyango lomhlaza wemiphunga oluphindaphindiweyo ibandakanya ukulinganisa izinto ezahlukeneyo ezibandakanya ukusebenza kakuhle, ubuthi, kunye nokukhethwa kwesigulana. Le theyibhile ilandelayo ithelekisa iindlela eziphambili zonyango ezikhoyo ngo-2026.
| Indlela yoNyango | Iimpawu eziphambili | Iprofayile yesigulane esifanelekileyo |
|---|---|---|
| I-Antibody-Drug Conjugates (ADCs) | Ukuhanjiswa okujoliswe kuko kwee-agent ze-cytotoxic; ukusebenza okuphezulu kwiinguqu ezithile | Izigulane ezine-HER2 okanye i-TROP2 intetho; ukuqhubela phambili kwe-post-TKI |
| Ii-Antibodies eziBispecific | Ukujoliswa kabini kweendawo zokujonga izifo kunye nezinto zokukhula | izigulane ezine-PD-L1; abo bafuna ukuvuselelwa kokhuseleko lomzimba |
| I-Chemotherapy Umngeni kwakhona | Irekhodi yomkhondo eqinisekisiweyo; ukufumaneka kwangoko | Ukuphindaphinda emva kwexesha (> iinyanga ezi-6); isimo esihle sokusebenza |
| Unyango lokuManyaniswa kwendawo | Udibanisa ulawulo lwenkqubo kunye nokupheliswa kwendawo | isifo se-Oligometastatic; ukusabela kunyango lokungeniswa |
| Inoveli Immunotherapies | Iindlela ezintsha zokusebenza; ezinokubakhona iimpendulo ezanelisayo | Ukuqhubela phambili kumgangatho wePD-(L)1 inhibitors; ulingo lwezonyango lufanelekile |
Olu thelekiso lubonisa ukuba akukho ndlela inye ifanele zonke. Ukhetho luxhomekeke kakhulu kwi-molecular makeup ye-tumor ephindaphindiweyo kunye nembali yonyango yangaphambili yesigulane.
Ukukhangela ukuxilongwa komhlaza wemiphunga ophindaphindiweyo kunokuba nzima. Ukuthatha amanyathelo acwangcisiweyo kunokunceda izigulane kunye nabanakekeli balawule imeko ngokufanelekileyo kwaye benze izigqibo ezinolwazi malunga unyango lomhlaza wemiphunga oluphindaphindiweyo.
Ukubandakanyeka ngokusebenzayo kwinkqubo yokunyamekela kunika amandla izigulane kwaye kaninzi kukhokelela kwiziphumo ezingcono. Amaqela enkxaso kunye nemibutho exhasa izigulane inokubonelela ngezixhobo ezixabisekileyo kunye nenkxaso yeemvakalelo.
Ukugqiba phakathi konyango olundlongo-ndlongo kunye nokhathalelo lokuthomalalisa lithuba elibalulekileyo. Indledlana nganye ineengenelo ezahlukeneyo kunye nentsilelo ekufuneka iqwalaselwe ngononophelo.
Isigqibo kufuneka sibe namandla, sihlaziywe rhoqo njengoko umfanekiso wekliniki uguquka. Izigulana ezininzi zifumana indawo ephakathi, zisebenzisa unyango olusebenzayo ngelixa zibeka phambili umgangatho wobomi ngeenkonzo ezidityanisiweyo zokhathalelo lwempilo.
Intsimi ye unyango lomhlaza wemiphunga oluphindaphindiweyo ikhula ngokukhawuleza, kukho izifundo ezininzi eziqhubayo ukujongana neemfuno ezingafezekiswanga. Imikhomba-ndlela yexesha elizayo yalatha kunyango olulolwakho ngakumbi kunye nonyango olungenatyhefu.
Uphando kwisizukulwana sesine se-EGFR inhibitors lujolise ekoyiseni ukuxhathisa kwe-C797S, umqobo omkhulu kwi-EGFR-mutant NSCLC. Ulingo lwesigaba sakwangoko lucebisa ukuba ezi arhente zinokubuyisela ubuntununtunu kumathumba awayekade enqabile.
Ukongeza, ukuphononongwa kogonyo lwe-neoantigen kunye nogonyo lomhlaza olwenzelwe umntu lunesithembiso esikhulu. Ngokuqeqesha amajoni omzimba ukuba abone iimpawu ezikhethekileyo zethumba, olu nyango lunokubonelela ngokhuseleko oluhlala ixesha elide ngokuchasene nokuphinda.
I-Artificial Intelligence (AI) iqala ukudlala indima eguqulayo kulawulo lomhlaza wemiphunga. Ii-algorithms ze-AI zinokuhlalutya izixa ezikhulu zokucinga kunye nedatha ye-genomic ukuqikelela umngcipheko wokuphindaphinda kunye nokucebisa iindlela ezifanelekileyo zonyango.
Izixhobo zempilo zedijithali zenza ukuba kubekwe iliso elikude kwizigulane, ukulandelela iimpawu kunye nokubambelela kumayeza ngexesha langempela. Olu tshintsho luqhubekayo lwengxelo luvumela ungenelelo olukhawulezayo kunye nohlengahlengiso lokhathalelo lomntu.
Ngaphaya koko, amaqonga aqhutywa yi-AI aququzelela ukulungelelaniswa kwezigulana kulingo olufanelekileyo lwezonyango, ukukhawulezisa ubhaliso kunye nokuqinisekisa ukuba abantu abafanelekileyo abaphoswa ngamathuba anokwandisa ubomi.
Imbonakalo yomhlaba ye unyango lomhlaza wemiphunga oluphindaphindiweyo ngo-2026 luphawulwa ngokuchaneka okungazange kubonwe ngaphambili kunye nokutsha. Ukususela ekwamkelweni kwenkqubo yesiteji ye-AJCC ye-9th Edition ukuya ekuhanjisweni kwe-ADCs eziphambili kunye ne-bispecific antibodies, izigulane zineenketho ezininzi kunanini ngaphambili.
Izinto eziphambili ezithathayo ziquka ukubaluleka okubalulekileyo kokuphinda uvavanyo lwe-biomarker, ixabiso lezicwangciso ezidityanisiweyo zamaqela asemngciphekweni omkhulu, kunye nendima ekhulayo yokuhlanganiswa kwendawo kwisifo se-oligometastatic. Njengoko uphando luqhubeka lubonakala, ikamva lithembisa ngakumbi unyango olusebenzayo nolulungiselelweyo.
Izigulana kunye nabakhathaleli bayakhuthazwa ukuba bahlale benolwazi, bazibandakanye namaqela abo okhathalelo lwempilo, kwaye bathathele ingqalelo iimvavanyo zeklinikhi njengendlela esebenzayo. Ngendlela eyiyo, umhlaza wemiphunga ophindaphindiweyo unokulawuleka ngokufanelekileyo, ukwandisa ukuphila kunye nokugcina umgangatho wobomi.