PD-1抑制剂联合GP方案治疗晚期三阴性乳腺癌患者的临床疗效及预后  

Clinical Efficacy and Prognosis of PD-1 Inhibitor Combined with GP Regimen for Advanced Triple-negative Breast Cancer

作　　者：殷雨来 任悦 张恒乐 张辉 白杰[2] 康晓宁[3] 靳丽君 王遵义[2] 张晓宇 YIN Yulai;REN Yue;ZHANG Hengle;ZHANG Hui;BAI Jie;KANG Xiaoning;JIN Lijun;WANG Zunyi;ZHANG Xiaoyu(Cangzhou Central Hospital,Hebei Medical University,Cangzhou 061000,China;Third Department of Thyroid and Breast Surgery,Cangzhou Central Hospital,Cangzhou 061000,China;Second Department of Ultrasound,Cangzhou Central Hospital,Cangzhou 061000,China)

机构地区：[1]河北医科大学附属沧州市中心医院,河北沧州061000 [2]沧州市中心医院甲状腺乳腺外三科,河北沧州061000 [3]沧州市中心医院超声二科,河北沧州061000

出　　处：《中国医药指南》2023年第10期18-21,共4页Guide of China Medicine

摘　　要：目的探究PD-1抑制剂联合GP方案治疗蒽环类和(或)紫杉类耐药的晚期三阴性乳腺癌患者的临床疗效及预后。方法收集在2019年11月至2021年11月就诊于沧州市中心医院的晚期三阴性乳腺癌患者78例,根据晚期TNBC患者所接受的不同治疗分为对照组(n=39)和观察组(n=39)。对照组和观察组均接受了吉西他滨联合顺铂(GP)化疗方案,观察组在GP化疗方案的基础上,给予卡瑞丽珠单抗注射液静脉注射。比较观察组和对照组的客观缓解率(ORR)和疾病控制率(DCR),无进展生存期(PFS)和总生存期(OS),并比较治疗前后观察组和对照组的胸苷激酶1(TK1)、肿瘤标志物水平(CEA、CA153、CA125)以及不良反应的发生情况。结果治疗后观察组的ORR(57.9%)和DCR(78.9%)均优于对照组(分别为32.4%和54.1%)(P<0.05)。观察组和对照组的PFS分别为7.00个月(95%CI:6.17~7.83)和4.50个月(95%CI:4.00~5.00);OS分别为9.40个月(95%CI:8.95~9.85)和6.50个月(95%CI:5.79~7.21),观察组的PFS和OS均长于对照组(P<0.001)。治疗后观察组和对照组的胸苷激酶1(TK1)较治疗前均无显著性差异(P>0.05),而肿瘤标志物CEA、CA153和CA125水平均出现了明显下降(P<0.001),且观察组的CEA水平低于对照组(P<0.05),而治疗后观察组和对照组的TK1、CA153、CA125水平以及不良反应发生率差别无显著性(P>0.05)。结论PD-1抑制剂联合GP方案治疗蒽环类和(或)紫杉类耐药的晚期三阴性乳腺癌患者的临床疗效及预后较好,且不良反应相对可控。Objective To investigate the clinical efficacy and prognosis of PD-1 inhibitors in combination with GP regimens for the treatment of anthracycline-and/or paclitaxel-resistant advanced triple-negative breast cancer patients Methods Seventy-eight patients with advanced triple-negative breast cancer who attended the Cangzhou Central Hospital from November 2019 to November 2021 were collected and divided into a control group(n=39)and an observation group(n=39)according to the different treatments received by patients with advanced TNBC.Both the control group and the observation group received gemcitabine combined with cisplatin(GP)chemotherapy regimen,and the observation group was given carrilizumab injection intravenously on top of GP chemotherapy regimen.The objective remission rate(ORR)and disease control rate(DCR),progression-free survival(PFS)and overall survival(OS)were observed in the observation group and the control group,and the levels of thymidine kinase 1(TK1),tumor markers(CEA,CA153,CA125)and the occurrence of adverse reactions in the observation group and the control group were compared before and after treatment.Results The ORR(57.9%)and DCR(78.9%)of the observation group were better than those of the control group(32.4%and 54.1%)after treatment(P<0.05).PFS was 7.00 months(95%CI:6.17-7.83)and 4.50 months(95%CI:4.00-5.00)in the observation group and control group,respectively;OS was 9.40 months(95%CI:8.95 to 9.85)and 6.50 months(95%CI:5.79-7.21),respectively.Both PFS and OS were longer in the observation group than in the control group(P<0.001).There was no statistical difference in thymidine kinase 1(TK1)in both the observation and control groups after treatment compared with that before treatment(P>0.05),while the levels of tumor markers CEA,CA153 and CA125 all showed a statistically significant decrease(P<0.001),and the CEA level in the observation group was lower than that in the control group(P<0.05),the levels of TK1,CA153 and CA125 and incidence of adverse reactions in the observation and control

关 键 词：三阴性乳腺癌 PD-1抑制剂 卡瑞丽珠单抗 吉西他滨 顺铂 疗效 

分 类 号：R737.9[医药卫生—肿瘤]