贝伐珠单抗联合培美曲塞/顺铂方案一线治疗EGFR野生型晚期肺腺癌的效果分析  

Efficacy and safety of bevacizumab combined with regimen of pemetrexed/cisplatin as the first-line therapy for advanced lung adenocarcinoma patients with EGFR wild-type

作　　者：张倩[1] 王伟[1] 徐春华[1] ZHANG Qian;WANG Wei;XU Chunhua(Department of Respiratory,Nanjing Chest Hospital,Nanjing 210029,China)

机构地区：[1]南京市胸科医院呼吸内科,南京210029

出　　处：《临床肿瘤学杂志》2019年第4期359-363,共5页Chinese Clinical Oncology

摘　　要：目的探讨贝伐珠单抗联合培美曲塞/顺铂方案一线治疗表皮生长因子受体(EGFR)野生型晚期肺腺癌的疗效及安全性。方法收集本院2014年6月至2017年1月经病理确诊的62例晚期肺腺癌患者(首次基因检测为EGFR野生型),其中研究组32例接受贝伐珠单抗联合培美曲塞/顺铂方案,对照组30例仅接受培美曲塞/顺铂方案,分别采用实体瘤的疗效评价标准(RECIST)1.1和美国国立癌症研究所通用毒性反应标准(NCI-CTC)3.0版评价疗效和不良反应,Kaplan-Meier法进行生存分析。结果全组均可评价近期疗效。研究组的有效率和疾病控制率分别为65.6%(21/32)和90.6%(29/32),高于对照组的33.3%(10/30)和66.7%(20/30),差异均有统计学意义(P<0.05)。研究组的中位无进展生存期和总生存期分别为8.0个月(95%CI:7.2～9.0个月)和19.0个月(95%CI:16.9～21.1个月),均长于对照组的6.0个月(95%CI:4.9～7.1个月)和15.0个月(95%CI:13.7～16.3个月),差异有统计学意义(P<0.05)。两组的药物不良反应主要表现为骨髓抑制、胃肠道反应、肝肾功能损伤。研究组的高血压发生率较对照组高,但差异接近有统计学意义(P=0.053)。结论贝伐珠单抗联合培美曲塞/顺铂方案对EGFR野生型晚期肺腺癌具有较好的疗效,且患者的耐受性较好,在临床治疗中有一定推广价值。Objective To evaluate the efficacy and safety of bevacizumab combined with regimen of pemetrexed/cisplatin in the first-line treatment of advanced lung adenocarcinoma patients with epidermal growth factor receptor (EGFR) wild-type. Methods A total of sixty-two patients with advanced lung adenocarcinoma confirmed by histopathology from June 2014 to January 2017 were analyzed retrospectively. All patients were wild-type EGFR by the first gene detection. Thirty-two patients in the study group received pemetrexed plus cisplatin combined with bevacizumab, and 30 patients in the control group received pemetrexed plus cisplatin. The efficacy and adverse reactions were evaluated by RECIST 1.1 and NCI-CTC 3.0, respectively. Survival analysis was performed by Kaplan-Meier method. Results The short-term curative effect can be evaluated in all patients. The response rate and disease control rate were 65.6%(21/32) and 90.6%(29/32) in the study group, higher than 33.3%(10/30) and 66.7%(20/30) in the control group with significant difference ( P < 0.05). The median progression-free survival and overall survival of the study group were 8.0 (95%CI: 7.2-9.0) and 19.0 (95%CI: 16.9-21.1) months, longer than 6.0 (95%CI: 4.9-7.1) and 15.0 (95%CI: 13.7-16.3) months of control group ( P < 0.05). The main adverse drug reactions of the two groups were bone marrow suppression, gastrointestinal reaction, liver and kidney function damage. The incidence of hypertension in the study group was higher than that in the control group, but the difference was close to statistical significance ( P = 0.053). Conclusion Bevacizumab combined with regimen of pemetrexed/cisplatin has a definitive clinical efficacy in advanced lung adenocarcinoma patients with EGFR wild-type, without increase of adverse drug reactions, possessing a certain popularization value in clinical treatment.

关 键 词：肺腺癌 贝伐珠单抗 表皮生长因子受体 野生型 

分 类 号：R734.2[医药卫生—肿瘤]