Efficacy of camrelizumab in treatment of advanced non small cell lung cancer in patients with brain metastases and its correlation with drive gene mutation
Objective To investigate the clinical efficacy of camrelizumab in the treatment of stage Ⅲb and Ⅳ advanced non small cell lung cancer(NSCLC)with brain metastases and explore the impact of driver gene mutation on therapeutic efficacy.Methods The clinical data of 98 NSCLC patients with brain metastasis admitted to the Affiliated Hospital of Huaibei Vocational and Technical College from January 2020 to January 2022 were retrospectively analyzed.They were divided into the control group(n=51)and the observation group(n=47)based on whether or not they were treated in combination with camrelizumab.Patients in both groups were treated with concurrent chemoradiotherapy and stereotactic radiosurgery.In addition,the patients in the observation group received additional treatment with injection of camrelizumab.Patients in the observation group were divided into two subgroups based on their brain metastases:single brain metastases and multiple brain metastases.Meanwhile,they were also divided into two subgroups based on their driver gene mutations:positive and negative.Objective remission rate and prognosis were compared between the observation group and the control group,as well as the subgroups of the observation group.Results After treatment,the results of short-term efficacy determination showed that the objective response rate in the observation group was significantly higher than that in the control(36.17%(17/47)vs 23.53%(12/51),χ2=4.305,P<0.05).After one-year of follow-up,the progression-free survival time((9.45±1.16)months vs(6.34±1.05)months,χ2=6.385,P<0.05)and overall survival time((13.69±2.15)months vs(10.41±1.19)months,χ2=7.743,P<0.05)in the observation group were both longer than those of the control group.There were 18 patients with single brain metastasis and 29 patients with multiple brain metastasis in the observation group.The objective response rate(χ2=4.748,P<0.05),progression-free survival time(χ2=7.458,P<0.05),and overall survival time(χ2=9.401,P<0.05)in the patients with single brain metastasis were higher than those in the patients with multiple brain metastasis.Among the patients with brain metastasis,there were 6 with driver gene mutation and 41 without.The overall survival time((15.46±3.16)months vs(7.86±1.85)months)and progression-free survival time((12.03±1.960)months vs(5.41±1.17)months)in the patients with driver gene mutation were higher than those in the patients without,and the differences were statistically significant(χ2=11.254,6.988,both P<0.05).Conclusion Camrelizumab demonstrates a better overall clinical outcome for NSCLC patients with brain metastases.Furthermore,the ORR is higher in SBM patients than in MBM patients.NSCLC is more sensitive to camrelizumab treatment in those patients with driver gene mutation.
Non small cell lung cancerCamrelizumabTumor stageBrain metastasis
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