程序性死亡受体1单抗治疗多线化疗失败晚期肿瘤患者的疗效及安全性分析  

Analysis on efficacy and safety of programmed cell death 1 antibody in the treatment of advanced cancer patients with multi-line chemotherapy failure

作　　者：赵盼 桑蝶 张育荣 范善民 ZHAO Pan;SANG Die;ZHANG Yurong;FAN Shanmin(Department of Medical Oncology,Beijing Chaoyang District Sanhuan Cancer Hospital,Beijing 100122,China)

机构地区：[1]北京市朝阳区三环肿瘤医院肿瘤内科,北京1001220

出　　处：《癌症进展》2020年第20期2091-2094,共4页Oncology Progress

摘　　要：目的评价程序性死亡受体1(PD-1)单抗治疗多线化疗失败晚期肿瘤患者的疗效和安全性。方法回顾性分析13例接受PD-1单抗治疗多线化疗失败的晚期肿瘤患者,接受PD-1单抗——特瑞普利单抗,与化疗和(或)靶向药物联合。参照免疫相关反应标准评价13例患者的疗效,免疫治疗相关毒性的管理(2020.V1)评价不良反应发生情况。结果给予PD-1单抗治疗期间获得完全缓解2例,部分缓解1例,疾病稳定7例,疾病进展3例,客观缓解率(ORR)为23.0%,临床获益率(CBR)为76.9%。所有患者随访3~13个月,中位随访时间为9个月,其中4例因疾病进展死亡,其余9例均生存,中位无进展生存期(PFS)为7个月,中位总生存期(OS)为9个月。13例晚期肿瘤患者的主要不良反应为血液学毒性,其次为类流感样症状、肝功能损伤和胃肠道反应;且多数为可耐受的Ⅰ~Ⅱ级不良反应,Ⅲ级及以上不良反应2例,其中Ⅲ级血淀粉酶升高1例,Ⅳ级白细胞下降1例,对症处理后均未影响继续治疗。结论PD-1单抗治疗多线化疗失败的晚期恶性肿瘤疗效满意,其总体不良反应低,安全性好。Objective To evaluate the efficacy and safety of anti-programmed cell death 1(PD-1)antibody in the treatment of advanced cancer patients with multi-line chemotherapy failure.Method A total of 13 patients with advanced cancer who failed to receive multi-line chemotherapy with anti-PD-1 antibody were retrospectively analyzed.The efficacy of 13 patients was evaluated according to the immune related response criteria,and the adverse reactions were evaluated by immunotherapy related toxicity management(2020.V1).Result During treatment with anti-PD-1 antibody,there were 2 cases of complete response(CR),1 case of partial response(PR),7 cases of stable disease(SD),3 cases of disease progression(PD),objective response rate(ORR)was 23.0%,and clinical benefit rate(CBR)was 76.9%.All patients were followed up for 3-13 months and the median follow-up time for 9 months,of which 4 cases died because of disease progression,the rest of the 9 cases were survival,the median progress free survival(PFS)was 7 months and the median overall survival(OS)was 9 months.Among the 13 cases of patients with advanced cancer,the main adverse reactions were hematological toxicity,the second adverse reactions were influenza-like symptoms,liver injury and gastrointestinal reactions.Mainly for the above tolerable toxicity level Ⅰ-Ⅱ level above adverse reaction in 2 cases,including Ⅲ level elevated blood amylase in 1 case,Ⅳ levels of white blood cells decline in 1 case,did not affect to continue treatment after symptomatic treatment.Conclusion Anti-PD-1 antibody exhibits significant efficacy and safety in the treatment of advanced cancer with multi-line chemotherapy failure,which has low toxic and good safety.

关 键 词：程序性死亡受体1 晚期肿瘤 疗效 不良反应 

分 类 号：R73[医药卫生—肿瘤]