摘要
目的:探讨替雷利珠单抗联合白蛋白结合型紫杉醇/奈达铂治疗晚期肺鳞癌的近期疗效及不良反应.方法:选取驱动基因表皮生长因子受体、间变性淋巴瘤激酶、C-ROS原癌基因阴性的晚期肺鳞癌病人 80 例,随机分为单纯化疗组和免疫联合化疗组,各40 例,分别给予白蛋白结合型紫杉醇/奈达铂和替雷利珠单抗联合白蛋白结合型紫杉醇/奈达铂治疗4 周期,比较2 组病人的近期疗效及主要不良反应.结果:免疫联合化疗组完全缓解(CR)1 例,部分缓解(PR)28 例,稳定(SD)9 例,进展(PD)2 例,客观缓解率(ORR)72.5%(29/40);疾病控制率(DCR)95%(38/40).单纯化疗组CR0 例,PR 13 例,SD 22 例,PD 5 例,ORR 37.5%(13/40),DCR 87.5%(35/40).免疫联合化疗组ORR明显高于单纯化疗组(P<0.01),2 组DCR差异无统计学意义(P>0.05).2 组病人白细胞计数减少、中性粒细胞计数减少、血小板计数减少、贫血、低蛋白血症、转氨酶升高、乏力、脱发、恶心、四肢疼痛等不良反应发生率差异均无统计学意义(P>0.05).结论:雷利珠单抗联合白蛋白结合型紫杉醇/奈达铂治疗晚期肺鳞癌较单纯化疗具有更佳的近期疗效,不会增加病人治疗期间的不良反应,安全性好,可以作为驱动基因阴性的晚期肺鳞癌病人的一线治疗方案.
Abstract
Objective:To investigate the short-term efficacy and adverse reactions of tislelizumab combined with nab-paclitaxel/nedaplatin in the treatment advanced lung squamous cell carcinoma.Methods:Eighty advanced lung squamous cell carcinoma patients with negative driver gene including epidermal growth factor receptor,anaplastic lymphoma kinase,and C-ROS oncogene 1 were selected and randomly divided into a simple chemotherapy group and an immunotherapy combined with chemotherapy group,with 40 cases in each group,which were treated with nab-paclitaxel/nedaplatin and tislelizumab combined with nab-paclitaxel/nedaplatin for 4 cycles,respectively.The short-term efficacy and major adverse reactions of patients in the two groups were compared.Results:In the immunotherapy combined with chemotherapy group,there was 1 case with complete remission(CR),28 cases with partial remission(PR),9 cases with stable disease(SD),and 2 progressive disease(PD),and the objective remission rate(ORR)was 72.5%(29/40),the disease control rate(DCR)was95%(38/40).In the simple chemotherapy group,there was 0 case with CR,13 cases with PR,22 cases with SD,5 cases with PD,and the ORR was 37.5%(13/40),DCR was 87.5%(35/40).The ORR in the immunotherapy combined with chemotherapy group was significantly higher than that in the simple chemotherapy group(P<0.01),but there was no statistically significant difference in DCR between the two groups(P>0.05).There was no statistically significant difference in the incidence of adverse reactions such as decreased white blood cell count,decreased neutrophil count,decreased platelet count,anemia,hypoalbuminemia,elevated transaminases,fatigue,hair loss,nausea,and limb pain of patients between the two groups(P>0.05).Conclusions:Tislelizumab combined with nab-paclitaxel/nedaplatin in the treatment of advanced lung squamous cell carcinoma has better short-term efficacy than simple chemotherapy,does not increase incidence of adverse reactions in patients during the treatment period,and has good safety,which may be used as the first-line treatment for advanced lung squamous cell carcinoma patients with negative driver gene.
基金项目
安徽省高校自然科学研究重点项目(KJ2018A0997)
NETL
NSTL
维普
万方数据