Clinical efficacy of pemetrexed maintenance chemotherapy combined with PD-1/PD-L1 inhibitors for advanced non-small cell lung cancer
Objective To study the effect of pemetrexed maintenance chemotherapy combined with programmed death receptor-1(PD-1)/programmed death receptor ligand 1(PD-L1)inhibitors for advanced non-small cell lung cancer(NSCLC).Methods 58 patients with advanced NSCLC were studied and divided into a control group and a study group according to different treatment methods,with 29 cases in each group.The control group was treated with pemetrexed maintenance chemotherapy,while the study group was treated with pemetrexed maintenance chemotherapy and PD-1/PD-L1 inhibitor(nivolumab injection)based on the control group.Patients in both groups were compared in terms of T lymphocyte subsets(CD3+,CD4+,CD8+,CD4+/CD8+),serum tumor markers[neuron-specific enolase(NSE),carcinoembryonic antigen(CEA),serum cancer antigen 125(CA125),serum cytokeratin 19 fragment(CY-FRA21-1)]before and after treatment,therapeutic effect,incidence of toxic and side effects.Results After treatment,the study group had higher levels of CD3+,CD4+,CD4+/CD8+and lower level of CD8+than those before treatment(P<0.05).After treatment,the study group had lower CD8+of(26.24±4.06)%than(34.97±4.25)%in the control group;the study group had CD3+of(62.93±4.87)%,CD4+of(37.35±4.18)%and CD4+/CD8+of(1.41±0.22),which were higher than(52.16±4.43)%,(30.11±4.04)%and(0.86±0.19)in the control group(P<0.05).After treatment,the levels of NSE,CEA,CA125 and CY-FRA21-1 in both groups were lower than those before treatment(P<0.05).After treatment,the study group had NSE of(16.21±4.04)ng/ml,CEA of(29.96±4.52)ng/ml,CA125 of(49.91±6.63)U/ml and CY-FRA21-1 of(6.76±3.15)ng/ml,which were lower than(20.94±4.09)ng/ml,(60.08±5.34)ng/ml,(79.85±7.08)U/ml and(11.08±3.27)ng/ml in the control group(P<0.05).After treatment,the study group had higher total effective rate of 93.10%than 65.52%in the control group(P<0.05).There was no difference in the incidence of toxic and side effects between the two groups(P>0.05).Conclusion Pemetrexed maintenance chemotherapy combined with PD-1/PD-L1 inhibitors has a significant effect in the treatment of advanced NSCLC,which can effectively reduce the level of serum tumor markers and enhance the immune function of patients with less toxic side effects.
PemetrexedNivolumab injectionAdvanced non-small cell lung cancerToxic and side reaction
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