程序性死亡受体1抑制剂联合血管内皮生长因子受体抑制剂治疗晚期卵巢癌临床观察  

Clinical observation of programmed death-1 inhibitor and vascular endothelial growth factor receptor inhibitor in the treatment of advanced ovarian cancer

作　　者：李冬荟 张钟月 娄世同 张伟杰[1] LI Donghui;ZHANG Zhongyue;LOU Shitong;ZHANG Weijie(Department of Oncology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院肿瘤科,河南郑州450052

出　　处：《肿瘤基础与临床》2022年第1期13-18,共6页journal of basic and clinical oncology

基　　金：河南省医学科技攻关(省部共建)计划项目(SBGJ202003027);希思科—君实肿瘤免疫研究基金(YJS2019-106)。

摘　　要：目的观察程序性死亡受体1(PD-1)抑制剂联合血管内皮生长因子受体(VEGFR)抑制剂用于二线及以上治疗失败的晚期卵巢癌患者的疗效及不良反应。方法回顾性分析郑州大学第一附属医院2019年1月至2021年12月期间收治的66例符合条件的晚期卵巢癌患者的临床资料,观察并记录其的客观缓解率、疾病控制率、疾病无进展生存时间,评估影响患者预后的因素。结果66例可评价疗效患者中完全缓解0例、部分缓解16例、疾病稳定26例、疾病进展24例,客观有效率为24.2%,疾病控制率为63.6%;中位疾病无进展生存时间为4.3个月。ECOG评分(P=0.004)、既往有无手术治疗(P<0.001)影响患者疾病无进展生存时间。将单因素COX回归分析差异有统计学意义的因素ECOG评分(P=0.007)、疲劳(P=0.043)、既往有无手术治疗(P<0.001)纳入多因素COX回归分析,结果显示ECOG评分(HR=2.694,P=0.045)、既往有无手术(HR=0.093,P<0.001)是影响患者疾病无进展生存时间的独立预后因素。治疗期间常见的不良反应为疲劳、食欲减退、反应性毛细血管增生症、手足综合征、腹泻等,均可耐受,大多为轻中度。结论PD-1抑制剂联合VEGFR抑制剂用于二线及以上治疗失败的晚期卵巢癌的治疗有一定疗效,不良反应可控,耐受性好,值得进一步研究。Objective To observe the efficacy and adverse effects of programmed death-1(PD-1)inhibitor and vascular endothelial growth factor receptor(VEGFR)inhibitor in the treatment of Advanced ovarian cancer progressing after more than two lines of systemic therapy.Methods The clinical data of 66 patients who were hospitalized in the First Affiliated Hospital of Zhengzhou University from January 2019 to December 2021 were retrospectively analyzed.The objective response rate,disease control rate,progression-free survival were observed and recorded.The factors that affected the patient’s prognosis were observed.Results Among 66 patients,none had complete remission,16 patients had partial remission,26 patients had stable disease,24 patients had disease progression,the objective response rate was 24.2%,and the disease control rate was 63.6%.The median progression-free survival was 4.3 months.ECOG scores(P=0.016)and past-operation history(P<0.001)affected patient’s progression-free survival.The meaningful factors of single factor COX analysis[ECOG scores(P=0.007),fatigue(P=0.043),past-operation history(P<0.001)]were divided into multiple factor COX analysis.It showed that ECOG scores(HR=2.694,P=0.045),past-operation history(HR=0.093,P<0.001)were independent factors of progression-free survival in patients with advanced ovarian cancer.Common treatment-related adverse effects were fatigue,anorexia,reactive cutaneous capillary endothelial proliferation,hand-foot syndrome,diarrhea and so on.The treatment-related adverse effects were tolerated.Conclusion PD-1 Inhibitor and VEGFR inhibitor showed a certain clinical efficacy and tolerable adverse effects and worth further study.

关 键 词：晚期卵巢癌 程序性死亡受体1抑制剂 血管内皮生长因子受体抑制剂 临床疗效 安全性 

分 类 号：R737.31[医药卫生—肿瘤]