贝伐珠单抗治疗初治卵巢癌患者的真实世界研究  

Real world study of bevacizumab treatment in patients with primary diagnosed ovarian cancer

作　　者：张楠[1] 郑虹[1] 高雨农[1] 舒桐 王红国 ZHANG Nan;ZHENG Hong;GAO Yunong;SHU Tong;WANG Hongguo(Gynecology Department,Peking University Cancer Hospital and Institute,Key Laboratory of Carcinogenesis and Translational Research,Ministry of Education of People’s Republic of China,Beijing,100142,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所妇科,恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《肿瘤药学》2023年第1期69-76,共8页Anti-Tumor Pharmacy

摘　　要：目的旨在评价贝伐珠单抗在初治晚期卵巢癌患者中的应用模式、依从性、有效性和安全性。方法回顾性分析2012年5月至2022年1月在我院初次诊治并接受贝伐珠单抗治疗的组织学确诊为上皮性卵巢癌、输卵管癌和原发性腹膜腺癌患者的临床病历资料,采用查阅病历和电话、门诊随访等方式收集随访资料,分析患者的临床病理特点,并评价贝伐珠单抗的疗效和安全性。结果本研究共纳入77例患者,其中35例仅在新辅助化疗(NT)期间使用贝伐珠单抗,23例在新辅助化疗和一线化疗(NT+FL)期间均使用贝伐珠单抗,19例仅在一线化疗(FLA)期间使用贝伐珠单抗。在43例接受间歇性肿瘤细胞减灭术(IDS)的NT和NT+FL患者中,有38例(88.4%)实现了满意减瘤,24例(55.8%)在IDS后无残留病灶。患者的中位无进展生存期(PFS)为15个月(95%CI:9.951~20.049),12个月的PFS率为61.7%。有7例(9.1%)患者因不良反应停用贝伐珠单抗。与贝伐珠单抗治疗相关的最常见不良反应是高血压。结论在真实世界中,贝伐珠单抗在初治卵巢癌的治疗中有效且耐受性良好;在新辅助化疗中加入贝伐珠单抗是安全可行的,患者术前最后一次化疗采用含贝伐珠单抗方案未导致术中出血量增加;对于贝伐珠单抗的用药剂量、疗程、用药模式及相关不良反应,还需更多前瞻性临床研究进一步证实。Objectives To retrospectively evaluate the pattern,compliance,efficacy and safety of bevacizumab in patients with primary diagnosed advanced ovarian cancer.Methods We reviewed the clinicopathological data of the patients with histologically confirmed epithelial ovarian cancer,fallopian tube cancer and primary peritoneal adenocarcinoma,who were treated in our hospital between May 2012 and January 2022.The medical records were reviewed,and follow-up information was collected for analysis of the patients'clinicopathological characteristics as well as the effectiveness and safety of bevacizumab.Results A total of 77 patients were ultimately enrolled in this study.Among all the patients,35 received bevacizumab during neoadjuvant chemotherapy alone(NT),23 received bevacizumab during both neoadjuvant and first-line chemotherapy(NT+FL)and 19 received bevacizumab during first-line chemotherapy alone(FLA).Among the 43 patients in NT and NT+FL groups undergoing interval debulking surgery(IDS),38 patients(88.4%)achieved optimal debulking,and 24 patients(55.8%)had no residual lesions after IDS.The patients in the FL group had a median PFS of 15(95%CI:9.951~20.049)months,and the 12-month PFS was 61.7%.Seven patients(9.1%)discontinued bevacizumab due to toxicity.The most common adverse event associated with bevacizumab treatment was hypertension.Conclusion Bevacizumab was effective and well-tolerated in the real-world setting of ovarian cancer treatment.Adding bevacizumab to neoadjuvant chemotherapy was feasible and tolerable.The last preoperative chemotherapy with bevacizumab did not result in increased intraoperative blood loss.More prospective clinical studies are needed to further confirm the dosage,course,mode of administration and related adverse reactions of bevacizumab.

关 键 词：妇科肿瘤 卵巢癌 贝伐珠单抗 真实世界研究 新辅助化疗 维持治疗 

分 类 号：R737.31[医药卫生—肿瘤]