目的 探讨纳武利尤单抗联合伊匹木单抗一线治疗局部晚期肺腺癌患者的疗效和安全性.方法 92例局部晚期肺腺癌患者,随机分为对照组及联合组,每组46例.对照组采用培美曲塞联合顺铂新辅助治疗,联合组采用纳武利尤单抗联合伊匹木单抗新辅助治疗.比较两组疾病控制率(disease control rate,DCR)、客观缓解率(objective response rate,ORR)、安全性以及肿瘤降期率、主要病理缓解(major pathological response,MPR)、完全病理缓解(pathological complete response,pCR)率和肿瘤标志物差异.结果 联合组ORR、DCR、肿瘤降期率高于对照组(P＜0.05),Ⅲ度及以上不良反应率低于对照组(P＜0.05).两组治疗2个月血清癌胚抗原(carcino-embryonic antigen,CEA)、细胞角蛋白19片段抗原21-1(cytokeratin 19 fragment antigen 21-1,Cyfra21-1)、神经元特异性烯醇化酶(neurone-specific enolase,NSE)水平均较治疗前降低(P＜0.05),联合组治疗2个月血清CEA、Cyfra21-1及NSE水平明显低于对照组(P＜0.05).结论 纳武利尤单抗联合伊匹木单抗一线治疗局部晚期肺腺癌可提高ORR、DCR及肿瘤降期率,且不良反应在可控范围内.
Value of nabuliumab combined with ipilimumab in the treatment of locally advanced lung adenocarcinoma
Objective To evaluate the efficacy and safety of nabuliumab combined with ipilimumab in the first-line treatment of locally advanced lung adenocarcinoma.Methods Ninety-two patients with locally advanced lung adenocarcinoma were randomly divided into control group and combined group by random number table method,46 cases in each group.The control group received pemetrexed combined with cisplatin,and the combined group received nabuliumab combined with ipilimumab.Disease control rate(DCR),objective response rate(ORR),safety,tumor downstaging rate,major pathological response(MPR),pathological complete response(pCR)rate and tumor markers were compared between the two groups.Results The rates of ORR,DCR,tumor downstaging in the combined group were higher than those in the control group(P＜0.05),and the incidence of adverse reaction in grade Ⅲ and above was lower than that in the control group(P＜0.05).After 2 months of treatment,serum carcino-embryonic antigen(CEA),cytokeratin 19 fragment antigen 21-1(Cyfra21-1)and neurone-specific enolase(NSE)levels in 2 groups were decreased compared with those before treatment(P＜0.05),and serum CEA,Cyfra21-1 and NSE levels in combined group were significantly lower than those in control group(P＜0.05).Conclusion Nabuliumab combined with ipilimumab in the first-line treatment of locally advanced lung adenocarcinoma can increase ORR,DCR,tumor descending stage rate,and the adverse reactions are controllable.
NETL
NSTL
万方数据
