免疫检查点抑制剂治疗晚期结直肠癌的疗效观察  

Efficacy observation of immune checkpoint inhibitors in metastatic colorectal cancer

作　　者：胡诗琪 许隽颖[2] 孙清[3] 王腾[4] 张迦维[3] 俞卫卫 潘德键 HU Shiqi;XU Juanying;SUN Qing;WANG Teng;ZHANG Jiawei;YU Weiwei;PAN Dejian(Wuxi Taihu Clinical College of Anhui Medical University,904st Hospital of PLA,Jiangsu Wuxi 214044,China;Department of Oncology,Wuxi People's Hospital,Jiangsu Wuxi 214023,China;Department of Oncology,Wuxi Second People's Hospital,Jiangsu Wuxi 214002,China;Department of Oncology,Wuxi Fourth People's Hospital,Jiangsu Wuxi 214062,China)

机构地区：[1]安徽医科大学无锡太湖临床学院中国人民解放军联勤保障部队第九零四医院,江苏无锡214044 [2]无锡市人民医院肿瘤科,江苏无锡214023 [3]无锡市第二人民医院肿瘤科,江苏无锡214002 [4]无锡市第四人民医院肿瘤科,江苏无锡214062

出　　处：《现代肿瘤医学》2022年第17期3143-3146,共4页Journal of Modern Oncology

摘　　要：目的:观察及评价免疫治疗在转移性结直肠癌中的疗效及不良反应。方法:对23例接受免疫联合化疗治疗的微卫星高度不稳定(MSI-H)的转移性结直肠癌患者进行临床观察。患者每3周接受一次帕博利珠单抗200 mg,持续1年,直至进展、不可接受的毒性或停药,联合化疗方案为FOLFIRI或FOLFOX4。影像学评估每9周进行一次,为期12个月。主要观察终点是客观缓解率,次要终点为无进展生存期(progression-free survival,PFS)、总生存期(overall survival,OS)、安全性和耐受性。结果:本组部分缓解5例,病情稳定13例,疾病进展5例,客观缓解率21.7%,疾病控制率78.3%。Ⅰ/Ⅱ级不良反应事件有7例疲劳,4例ALT升高,3例皮疹,2例内分泌异常,腹泻和肺炎各1例。Ⅲ级不良反应事件仅有内分泌异常1例,无Ⅳ级不良反应事件。结论:免疫检查点抑制剂治疗MSI-H转移性结直肠癌患者有一定的疗效,且安全性良好。Objective:To observe and evaluate the efficacy and adverse effects of immunotherapy in metastatic colorectal cancer.Methods:23 patients with MSI-H metastatic colorectal cancer receiving immunotherapy combined chemotherapy were observed.Patients received Pembrolizumab 200 mg every 3 weeks for up to 1 year until progression,unacceptable toxicity,or withdrawal,combined with FOLFIRI or FOLFOX4.Imaging assessment is conducted every 9 weeks for 12 months.The primary end point was objective response rate(ORR),and the secondary end points were progression-free survival(PFS),overall survival(OS),safety and tolerability.Results:Among these 23 patients,objective rate was 21.7%and disease control rate was 78.3%,with 5 PR,13 SD,5 PD.GradeⅠ/Ⅱadverse events were asthenia in 7,ALT elevations in 4,rash in 3,endocrinopathies in 2,diarrhea in 1 and pneumonitis in 1.There was only 1 endocrinopathy in gradeⅢadverse events and no one in gradeⅣadverse events.Conclusion:Immune checkpoint inhibitors are effective and safe in the treatment of MSI-H metastatic colorectal cancer.

关 键 词：结直肠癌 免疫检查点抑制剂 帕博利珠单抗 

分 类 号：R735.3[医药卫生—肿瘤]