Efficacy of pembrolizumab combined with albumin-bound paclitaxel and capecitabine in treatment of patients with advanced gastric cancer
Objective To explore the efficacy of pembrolizumab combined with albumin-bound paclitaxel in the treatment of patients with advanced gastric cancer.Methods From October 2019 to October 2022,122 patients with advanced gastric cancer treated at Hong hui Hospital,Xi'an Jiaotong University were selected for the randomized controlled trial,and were divided into an observation group and a control group by the random number table method,with 61 cases in each group.There were 47 males and 14 females in the observation group who were(63.14±5.65)years old.There were 48 males and 13 females in the control group who were(62.45±5.47)years old.The control group were treated with the capecitabine regimen and albumin-bound paclitaxel;in addition,the observation group took pembrolizumab.The clinical efficacies,serum levels of tumor markers[carbohydrate antigen-724(CA-724),carbohydrate antigen-199(CA-199),vascular endothelial growth factor(VEGF),and tumor necrosis factor-α(TNF-α)]before and after the treatment,and adverse reactions were compared between the groups using t and x2 tests.Results The total effective rate in the observation group was higher than that in the control group[68.85％(42/61)vs.47.54％(29/61)],with a statistical difference(x2=5.509,P=0.019).Before the treatment,there were no statistical differences in the levels of CA-724,CA-199,VEGF,and TNF-αbetween the two groups(all P＞0.05).After the treatment,the levels of CA-724,CA-199,VEGF,and TNF-α in the observation group were lower than those in the control group[(17.56±2.22)μg/L vs.(22.53±2.49)μg/L,(21.56±3.21)U/ml vs.(27.52±3.44)U/ml,(271.64±21.22)ng/L vs.(281.33±24.15)ng/L,and(15.08±2.53)μg/L vs.(19.54±3.68)μg/L],with statistical differences(t=11.636,9.893,2.354,and 7.800;all P＜0.05).The incidence of grade Ⅲ-Ⅳ thrombocytopenia in the observation group was lower than that in the control group[4.92％(3/61)vs.18.03％(11/61)],with a statistical difference(x2=5.164,P=0.023).There were no statistical differences in the incidences of neutropenia,diarrhea,and hypothyroidism between the two groups(all P＞0.05).After one-year follow-up,the survival rate in the observation group was higher than that in the control group[95.08％(58/61)vs.83.61％(51/61)](x2=4.218,P=0.039).Conclusion The combination of pembrolizumab and albumin-bound paclitaxel for patients with advanced gastric cancer is effective,and can significantly reduce their levels of serum tumor markers.
万方数据
维普
