贝伐珠单抗联合治疗晚期非小细胞肺癌的疗效和安全性  

Efficacy and Safety of Bevacizumab Combination Therapy in Patients with Advanced Non-small Cell Lung Cancer

作　　者：石磊[1] 蒋继宗 刘青旭 张莉[1] 夏曙 陈元 褚倩[1] SHI Lei;JIANG Jizong;LIU Qingxu;ZHANG Li;XIA Shu;CHEN Yuan;CHU Qian(Cancer Center,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院肿瘤中心,武汉430030

出　　处：《医药导报》2018年第5期554-558,共5页Herald of Medicine

摘　　要：目的探讨贝伐珠单抗联合治疗对晚期非小细胞肺癌(NSCLC)患者的疗效和安全性。方法回顾性分析晚期NSCLC患者78例,根据治疗方案的不同分为4组,A组:一线化疗联合贝伐珠单抗治疗36例;B组:一线表皮生长因子受体酪氨酸激酶抑制药(EGFR-TKI)联合贝伐珠单抗治疗7例;C组:二线及二线以上化疗联合贝伐珠单抗治疗30例;D组:二线及二线以上EGFR-TKI联合贝伐珠单抗治疗5例。统计联合应用贝伐珠单抗患者的无进展生存期(PFS)、总生存期及不良反应发生情况。结果 A、B、C、D组疾病控制分别为34,6,26和4例;平均无进展时间(mPFS)为8.9,10.8,7.2和7.8个月,总生存时间数据尚不成熟。化疗联合贝伐珠单抗的主要不良反应与所联合的方案高度相关,包括骨髓抑制、疲乏、腹泻、高血压等,3或4级毒副反应主要为中性粒细胞减少15.2%(10/66)、腹泻4.5%(3/66)、疲乏7.6%(5/66)、高血压6.1%(4/66)。EGFR-TKI联合贝伐珠单抗的主要不良反应为高血压2例(2/12)、皮疹3例(3/12)、腹泻5例(5/12)、无症状蛋白尿2例(2/12)、疲乏2例(2,12)。未观察到3级以上不良反应。结论化疗或EGFR-TKI联合贝伐珠单抗是晚期NSCLC安全有效的治疗策略。Objective To investigate the efficacy and safety of bevacizumab in the systemic treatment of patients with advanced non-small cell lung cancer.Methods A total of 78 patients diagnosed with advanced non squamous non-small cell lung cancer were divided into 4 groups:36 patients in group A(first-line chemotherapy combined with bevacizumab),7 patients in group B[first-line epidermal growth factor receptor tyrosine kinase inhibitors(EGFR-TKI)combined with bevacizumab],30 patients in group C(two or more lines of chemotherapy combined with bevacizumab)and 5 patients in group D(two or more lines of EGFR tyrosine kinase inhibitor combined with bevacizumab).The progression-free survival(PFS),overall survival(OS)and adverse reactions were retrospectively analyzed.Results The disease control cases in each group were 34,6,26 and 4,respectively.The mean progression free survival(mPFS)in each group were 8.9 months,10.8 months,7.2 months and 7.8 months,respectively.The overall survival data is not mature.The main adverse reactions of chemotherapy combined with bevacizumab were myelosuppression,fatigue,diarrhea,and hypertension etc.grade 3 or 4 toxicities include neutropenia(10/66,15.2%),diarrhea(3/66,4.5%),fatigue(5/66,7.6%),hypertension(4/66,6.1%).The main adverse reactions of EGFR-TKI combined with bevacizumab were hypertension(2/12),rash(3/12),diarrhea(5/12),asymptomatic proteinuria(2/12)and fatigue(2/12),without grade above 3 toxicities.Conclusion Chemotherapy or EGFR-TKI combined with bevacizumab are safe and effective treatment strategies for advanced non-small cell lung cancer.

关 键 词：贝伐珠单抗 癌 肺 非小细胞 抗肿瘤血管生成 

分 类 号：R979.1[医药卫生—药品] R734.2[医药卫生—药学]