仑伐替尼联合卡瑞利珠单抗二线治疗晚期肝内胆管癌12例分析
Clinical analysis of the second-line treatment with lenvatinib plus camrelizumab in 12 cases of advanced intrahepatic cholangiocarcinoma
张建康 1刘意 1丁东 1王之怀 1沈宇航 1孙庆宇 1聂斌 2朱春富 1秦锡虎 3高源1
作者信息
- 1. 南京医科大学附属常州第二人民医院肝胆胰外科 肝胆胰疾病研究所,常州 213000
- 2. 南京医科大学附属常州第二人民医院肿瘤内科,常州 213000
- 3. 南京医科大学常州医学中心,常州 213000
- 折叠
摘要
目的 分析仑伐替尼联合卡瑞利珠单抗在晚期肝内胆管癌(ICC)二线治疗中的疗效及安全性.方法 回顾分析南京医科大学附属常州第二人民医院2021年6月至2022年6月采用仑伐替尼联合卡瑞利珠单抗作为二线治疗方案的晚期ICC患者临床资料.共入组12例患者,其中男性7例,女性5例,年龄(67.5±8.6)岁.采用改良实体瘤临床疗效评价标准1.1评价疗效,安全性评估采用不良事件评价标准5.0.Kaplan-Meier法绘制生存曲线.结果 12例患者用药1～7个周期后,3例达到部分缓解,4例达到疾病稳定,5例达到疾病进展.12例患者治疗1、3、6个月累积生存率及无进展生存率分别为100.0％、91.7％、66.7％和83.3％、41.7％、25.0％.12例患者中位总生存期为14.7(95％CI:9.2～21.2)个月,中无进展生存期为8.0(95％CI:4.1～11.9)个月.7例患者发生了不良事件,≥3级的不良事件3例:分别为高血压1例,予以口服降压药对症治疗后好转;总胆红素升高1例,仑伐替尼减量后好转;肝功能不全1例,停用卡瑞利珠单抗后好转.结论 仑伐替尼联合卡瑞利珠单抗作为晚期ICC的二线治疗生存获益尚可,不良事件可控,可作为晚期ICC二线治疗的选择.
Abstract
Objective To evaluate the efficacy and safety of lenvatinib combined with camrelizumab as the second-line treatment for advanced intrahepatic cholangiocarcinoma(ICC).Methods The clinical data of patients with advanced ICC undergoing the second-line treatment of lenvatinib combined with camreli-zumab in the Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University from June 2021 to June 2022 were screened and analyzed.A total of 12 patients were enrolled,including seven males and five females,aged(67.5±8.6)years.Response evaluation criteria in solid tumor 1.1 was used to evaluate the efficacy of treatment.The safety assessment adopts the Adverse Event Evaluation Standard 5.0.Kaplan-Meier method was conducted to plot survival curves.Results Among the 12 patients(after 1-7 cycles of immune and targeted therapy),three achieved partial response,four achieved stable disease,and five were defined as progression disease.Adverse events of different degrees occurred in seven cases,among which three patients had adverse events of grade ≥ 3:one with hypertension,which was managed after antihyper-tensive and symptomatic treatment;one with elevated serum total bilirubin,which was improved after reduc-ing the dose of lenvatinib;one with liver dysfunction,which was considered as immune-related liver toxicity and alleviated after discontinuing camrelizumab.The 1-month,3-month,and 6-month survival rates and progression-free survival rates of the patients were 100.0％,91.7％,66.7％,and 83.3％,41.7％,and 25.0％,respectively.The median overall survival of patients was 14.7 months(95％CI:9.2-21.2)and the median time to progression was 8.0 months(95％CI:4.1-11.9).Conclusion Combination of lenva-tinib and camrelizumab could bring survival benefits with controllable adverse events as the second-line treat-ment of patients with advanced ICC.
关键词
胆道肿瘤/分子靶向治疗/免疫治疗/疗效Key words
Biliary tract neoplasms/Molecular targeted therapy/Immunotherapy/Efficacy引用本文复制引用
基金项目
江苏省卫生健康委面上项目(M2022023)
常州市卫生健康卓越人才项目(2022CZZY005)
常州市社会发展项目(CE20215040)
出版年
2024
NETL
NSTL
万方数据