Clinical Efficacy and Safety of Fruquintinib Combined With PD-1 Inhibitors in Advanced Colorectal Cancer
OBJECTIVE To evaluate the efficacy and safety of fruquintinib combined with PD-1 inhibitors in the treatment of advanced colorectal cancer(CRC)in the third line and above.METHODS A retrospective analysis was performed on 93 patients diagnosed with advanced CRC who received fuquinitinib monotherapy or fuquinitinib combined with PD-1 inhibitors as third-line or higher treatment options in a hospital from January 2020 to August 2023.According to the treatment plan,the patients were divided into two groups:Fruquintinib monotherapy group(63 cases)and combined group(30 cases).Objective response rate(ORR),disease control rate(DCR),progression-free survival(PFS)and adverse reactions between the two groups were analyzed and compared.The differences of neutrophil lymphocyte ratio(NLR),platelet lymphocyte ratio(PLR),systemic immunoinflammatory index(SII)and prognostic nutritional index(PNI)between the two groups were further studied and analyzed.RESULTS The ORR in the combined group(16.7％)was significantly higher than that in the monotherapy group(6.3％),but the difference was not statistically significant(x2=2.475,P=0.116).Compared with the monotherapy group,the DCR in the combination group was significantly higher(66.7％),the difference was statistically significant(x2=5.244,P=0.022).After 2 cycles of treatment,PNI in combination group was significantly higher than that in monotherapy group,but there was no statistical significance in NLR,PLR,PNI and SII.There was no significant difference in CR,PR,SD,PD,ORR and DCR among mCRC patients in the combined group using different PD-1.Kaplan-Meier survival analysis showed that the median PFS in the combination group was longer than that in the monotherapy group(4.0 months vs.2.0 months),and the difference was statistically significant(x2=4.323,P=0.038).There was no significant difference in the incidence of adverse reactions and the incidence of adverse reactions ≥ grade 3 between the two groups.All patients'adverse reactions were controlled and resolved after symptomatic treatment or discontinuation of treatment,and no patients died from serious adverse reactions.CONCLUSION In the third-line and above mCRC treatment,compared with the fruquintinib monotherapy group,fruquintinib combined with PD-1 inhibitor has better benefits and controllable safety,which is worthy of further research.
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