首页|信迪利单抗联合安罗替尼治疗晚期非小细胞肺癌的临床分析

信迪利单抗联合安罗替尼治疗晚期非小细胞肺癌的临床分析

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目的 探索信迪利单抗联合安罗替尼治疗晚期非小细胞肺癌(NSCLC)的疗效和安全性。方法 回顾性分析2019年5月至2021年8月于本院就诊的信迪利单抗(200 mg ivgtt qd,第1日,21 d为一个周期)联合安罗替尼(10mgpoqd,第1~14日,停7d,21 d为一个周期)治疗的60例晚期NSCLC患者的临床资料。记录患者的临床特征、客观缓解率(ORR)、疾病控制率(DCR)、无进展生存期(PFS)和不良反应发生情况,分析不同临床特征与近期疗效的关系,多因素回归分析预后危险因素。结果 所有患者的ORR为33%,DCR为72%;其中29例一线治疗患者的ORR为52%、DCR为83%,31例二线及以上治疗患者的ORR为16%、DCR为61%。Ⅲ期患者有效率高于Ⅳ期患者(80%vs。24%,P<0。05),鳞癌患者有效率高于腺癌和其他病理类型患者(56%vs。13%vs。50%,P<0。05),一线治疗患者有效率高于二线及以上治疗患者(52%vs。16%,P<0。05)。所有患者的中位PFS为5。1个月,其中一线治疗患者为23。3个月,二线及以上的为3。0个月。一线治疗中位PFS远长于二线及以上(23。3个月vs。3。0个月,P<0。05)。年龄≥ 65岁患者较年龄<65岁患者疾病进展风险增加(HR=2。215,95%CI:1。043~4。705,P<0。05),ECOG 2分患者较ECOG 1分患者疾病进展风险增加(HR=8。905,95%CI:3。671~21。603,P<0。05),一线治疗患者较二线及以上治疗患者疾病进展风险降低(HR=0。233,95%CI:0。107~0。506,P<0。05)。不良反应总发生率为60%,≥3级不良反应占8%,分别为乏力、肝功能损伤和糖尿病,均在对症处理后改善。结论 信迪利单抗联合安罗替尼治疗晚期NSCLC具有一定疗效,且患者可耐受。年龄、ECOG评分和治疗线数是影响患者预后的独立危险因素。
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.

sintilimabanlotinibadvanced non-small cell lung cancerimmunotherapyantiangiogenic

朱金秀、谢强、黄燕芳、林岚、陈巧林、乐雨银

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福建省福州肺科医院肿瘤科,福建福州 350008

信迪利单抗 安罗替尼 晚期非小细胞肺癌 免疫治疗 抗血管生成

福州市市级科技计划

2019-SZ-58

2024

中国新药与临床杂志
中国药学会 上海市食品药品监督管理局科技情报研究所

中国新药与临床杂志

CSTPCD北大核心
影响因子:0.967
ISSN:1007-7669
年,卷(期):2024.43(3)
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