尽管以PD-1/PD-L1抑制剂为基础的免疫治疗显著提升了肺癌患者的生存期，但耐药问题依然严峻。本文阐述了免 疫治疗耐药的定义、发生机制及预测模型，介绍了针对耐药的治疗策略，包括免疫治疗继续应用、再挑战、寡转移背景下的局部治 疗联合全身免疫治疗、广泛进展后的联合治疗等。此外，还探讨了新型治疗手段如过继性细胞疗法、抗体偶联药物、双特异性抗 体和肿瘤疫苗等在克服耐药中的应用前景。同时，总结了肺癌免疫治疗的挑战与发展方向，强调了持续研究、创新治疗策略以及 跨学科合作的重要性。为未来肺癌治疗的个体化、精准化和高效化提供新思路与研究方向。

Despite significant improvements in survival among lung cancer patients treated with PD-1/PD-L1 inhibitor-based immunotherapy, the issue of drug resistance remains a major challenge. This article delineates the definition, mechanisms, and predictive models of immunotherapy resistance, and introduces therapeutic strategies to address resistance, including continued use of immunotherapy, rechallenge, local treatment combined with systemic immunotherapy in the context of oligometastasis, and combination therapy after extensive progression. Furthermore, it explores the application prospects of novel therapeutic approaches such as adoptive cell therapy, antibody-drug conjugates, bispecific antibodies, and tumor vaccines in overcoming drug resistance. Additionally, the article summarizes the challenges and development directions of immunotherapy for lung cancer, emphasizing the importance of ongoing research, innovative treatment strategies, and interdisciplinary collaboration. These efforts aim to provide new ideas and research directions for achieving personalized, precise, and efficient lung cancer treatment in the future.

吉林省科技厅项目（No. 20240304037SF）；吉林省人力资 源和社会保障厅项目（No. 2023RY03）