食管鳞癌抗PD-1免疫治疗失败后使用安罗替尼挽救治疗的效果及安全性  

Efficacy and safety of anlotinib salvage therapy for esophageal squamous cell carcinoma after ineffective anti-PD-1 immunotherapy

作　　者：宫海涛[1] 丁守然 林涛 Gong Haitao;Ding Shouran;Lin Tao(Department of OncologyⅢ,Yantian Laiyang Central Hospital,Laiyang 265200,China)

机构地区：[1]烟台市莱阳中心医院肿瘤三科,莱阳265200

出　　处：《中国实用医刊》2022年第20期105-108,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨食管鳞癌抗程序性死亡受体1(PD-1)免疫治疗失败后使用安罗替尼挽救治疗的效果及安全性。方法回顾性分析2019年1月至2021年1月莱阳中心医院收治的45例食管鳞癌患者的临床资料。所有患者在抗PD-1免疫治疗失败后予以安罗替尼挽救治疗,随访1年。记录患者近期疗效、预后情况、肿瘤标志物水平及不良反应发生情况。结果45例食管鳞癌患者经安罗替尼治疗后,客观缓解率为20.00%(9/45),疾病控制率为82.22%(37/45);中位无进展生存期为4.35个月,中位总生存期为9.89个月;治疗后,细胞角化素蛋白19片段(CYFA21-1)[(1.41±0.25)ng/ml]、癌胚抗原[(1.65±0.27)μg/ml]、鳞状上皮细胞癌相关抗原[(1.02±0.22)μg/ml]低于治疗前[(2.95±0.48)ng/ml、(3.08±0.51)μg/ml、(1.93±0.31)μg/ml],差异有统计学意义(P<0.05)。45例患者用药期间未出现与药物相关的死亡事件,不良反应以高血压、乏力、甲状腺功能减退为主,经积极对症治疗及调整药物剂量后均可维持治疗,无因不良反应停药者。结论安罗替尼在食管鳞癌抗PD-1免疫治疗失败后的挽救治疗中效果良好,能够提高疾病控制率,阻止肿瘤持续进展,且未出现严重不良反应,可作为后续挽救治疗的重要选择。Objective To investigate the efficacy and safety of salvage therapy with anlotinib in the treatment of esophageal squamous cell carcinoma after ineffective anti-programmed death receptor 1(PD-1)immunotherapy.Methods The clinical data of 45 patients with esophageal squamous cell carcinoma admitted to Laiyang Central Hospital from January 2019 to January 2021 were retrospectively analyzed.All patients received anlotinib salvage therapy after ineffective anti-PD-1 immunotherapy,and they were followed up for 1 year.The short-term efficacy,prognosis,tumor marker level and adverse reactions of the patients were recorded.Results The objective response rate of the 45 patients with esophageal squamous cell carcinoma after anlotinib salvage therapy was 20.00%(9/45),and the disease control rate was 82.22%(37/45);the median progression-free survival was 4.35 months,and the median overall survival was 9.89 months.After treatment,their cytokeratin protein fragment 19(CYFA21-1),carcinoembryonic antigen,squamous cell carcinoma-related antigen were(1.41±0.25)ng/ml,(1.65±0.27)μg/ml and(1.02±0.22)μg/ml,respectively,lower than the(2.95±0.48)ng/ml,(3.08±0.51)μg/ml,and(1.93±0.31)μg/ml before treatment,correspondingly,and the differences were significant(P<0.05).There was no drug-related death during the medication period among these 45 patients,and the adverse reactions were mainly hypertension,fatigue,and hypothyroidism.After active symptomatic treatment and adjustment of the drug dose,the treatment could be maintained,and there was no discontinuation due to adverse reactions.Conclusions Anlotinib has a good effect in salvage treatment after ineffective anti-PD-1 immunotherapy for esophageal squamous cell carcinoma,it can improve the disease control rate,prevent the continuous progression of the tumor,and has no serious adverse reactions.It can be an important choice for subsequent salvage treatment.

关 键 词：食管鳞癌 程序性死亡受体1 免疫治疗 安罗替尼 

分 类 号：R735.1[医药卫生—肿瘤]