Clinical analysis of sintilimab combined with anlotinib in treatment of advanced non-small cell lung cancer
AIM To explore the efficacy and safety of sintilimab combined with anlotinib in treatment of advanced non-small cell lung cancer(NSCLC).METHODS The clinical data of 60 patients with advanced NSCLC treated with sintilimab(200 mg ivgtt qd,on day 1,21 days per cycle)combined with anlotinib(10 mg po qd,taken for 14 d and stopped for 7 d,21 days per cycle)in our hospital from May 2019 to August 2021 were retrospectively analyzed.The patient's clinical characteristics,objective response rate(ORR),disease control rate(DCR),progression-free survival(PFS)and the occurrence of adverse reactions were recorded.The relationship between different clinical characteristics and short-term efficacy was analyzed,and the multivariate regression analysis was conducted to identify prognostic risk factors.RESULTS The ORR for all patients was 33%and the DCR was 72%.Among them,The ORR of 29 first-line treatment patients was 52%and DCR was 83%.The ORR of 31 second or above-line treatment patients was 16%and the DCR was 61%.The response rate of stage Ⅲ patients was higher than that in stage Ⅳ patients(80%vs.24%,P<0.05),and squamous cell carcinoma type had a higher response rate than adenocarcinoma and other pathological types(56%vs.13%vs.50%,P<0.05).The patients with first-line treatment had higher response rate than second-line treatment or above(52%vs.16%,P<0.05).The median PFS for all patients was 5.1 months.The median PFS in first-line treatment was significantly longer than that in second-line or above(23.3 months vs.3.0 months,P<0.05).The patients aged ≥ 65 years had an increased risk of disease progression compared with aged<65 years(HR=2.215,95%CI:1.043 to 4.705,P<0.05).The patients with ECOG scored 2 had an increased risk of disease progression compared with ECOG scored 1(HR=8.905,95%CI:3.671 to 21.603,P<0.05).First-line treatment patients had a lower risk of disease progression compared with second-line or above treatment(HR=0.233,95%CI:0.107 to 0.506,P<0.05).The overall incidence of adverse reactions was 60%,and the adverse reactions ≥ 3 grade accounted for 8%,which were fatigue,liver damage and diabetes.All of them were improved after symptomatic treatment.CONCLUSION Sintilimab combined with anlotinib in treatment of advanced NSCLC has a certain efficacy,and are well tolerated by patients.Age,ECOG score,and treatment lines are independent risk factors for prognosis.