安罗替尼联合白蛋白结合型紫杉醇治疗晚期肺癌的真实世界研究  

Real world research of anlotinib combined with albumin-bound paclitaxel in the treatment of advanced lung cancer patients

作　　者：丁佩 徐婪 陈州华 DING Pei;XU Lan;CHEN Zhouhua(Department of Oncology,the Second People’s Hospital of Xiangtan City,Xiangtan 411100,Hu’nan,China)

机构地区：[1]湘潭市第二人民医院肿瘤科,湖南湘潭4111000

出　　处：《癌症进展》2023年第6期615-620,共6页Oncology Progress

基　　金：湘潭市医学科研项目(2020xtyx-40)。

摘　　要：目的 探讨真实世界中安罗替尼联合白蛋白结合型紫杉醇治疗晚期肺癌的临床疗效及安全性。方法 选取至少经过一线治疗的晚期肺癌患者34例,采用安罗替尼联合白蛋白结合型紫杉醇治疗3周方案,持续用药至病情进展或患者不耐受。比较不同临床特征晚期肺癌患者的近期疗效,分析患者的生存情况及不良反应发生情况。结果 34例患者中,部分缓解10例(29.41%),疾病稳定10例(29.41%),客观缓解率(ORR)为29.41%,疾病控制率(DCR)为58.82%,中位无进展生存期为6.0个月(95%CI:5.4~6.6个月),中位总生存期为11.9个月(95%CI:10.8~12.9个月)。不同性别、年龄、吸烟史、病理类型、既往紫杉类药物化疗情况及既往抗血管生成治疗情况的晚期肺癌患者的ORR比较,差异均无统计学意义(P﹥0.05);ⅢC期、安罗替尼二线治疗的晚期肺癌患者的ORR分别高于Ⅳ期、安罗替尼三线及以上治疗的患者,差异均有统计学意义(P﹤0.05)。不同性别、年龄、吸烟史、既往紫杉类药物化疗情况及既往抗血管生成治疗情况的晚期肺癌患者的DCR比较,差异均无统计学意义(P﹥0.05);腺癌、ⅢC期、安罗替尼二线治疗的晚期肺癌患者的DCR分别高于非腺癌、Ⅳ期、安罗替尼三线及以上治疗的患者,差异均有统计学意义(P﹤0.05)。主要的不良反应为中性粒细胞减少、乏力、脱发、贫血、周围神经病变及高血压,多为1~2级,患者可耐受。结论 在真实世界中,安罗替尼联合白蛋白结合型紫杉醇可为晚期肺癌患者带来生存获益,且不良反应可耐受。Objective To investigate the clinical efficacy and safety of anlotinib combined with albumin-bound paclitaxel in the treatment of patients with advanced lung cancer in the real world.Method A total of 34 patients with advanced lung cancer who had received first line or above treatment were selected.All patients received three-week regimen of anlotinib combined with albumin-bound paclitaxel up to disease progression or intolerance.The short-term efficacy of patients with different clinical characteristics were compared,and the survival and adverse reactions were analyzed.Result There were 10 cases(29.41%)of partial response,10 cases(29.41%)of stable disease in 34 patients,the objective response rate(ORR)was 29.41%and the disease control rate(DCR)was 58.82%,the median progression-free survival(PFS)was 6.0(95%CI:5.4-6.6)months and the median overall survival(OS)was 11.9(95%CI:10.8-12.9)months.There were no significant differences for ORR in patients with different genders,ages,smoking history,pathological types,prior use of paclitaxel-based medications and previous anti-angiogenic therapy(P>0.05).The ORR in patients with stage IIIC and second line treatment of anlotinib were higher than those in patients with stage IV and third line or above treatment of anlotinib(P<0.05).There were no significant differences for DCR in patients with different genders,ages,smoking history,prior use of paclitaxel-based medications and previous anti-angiogenic therapy(P>0.05).The DCR in patients with adenocarcinoma,stage IIIC and second line treatment of anlotinib were higher than those in patients with non-adenocarcinoma,stage IV and third line or above treatment of anlotinib(P<0.05).Neutropenia,fatigue,alopecia,anemia,peripheral neuropathy and hypertension were commonly observed adverse reactions,and most of which were grade 1-2 and tolerable.Conclusion In the real world,anlotinib combined with albumin-bound paclitaxel bring survival benefits to advanced lung cancer patients,and the adverse reactions are relatively tolerable.

关 键 词：肺癌 安罗替尼 白蛋白结合型紫杉醇 客观缓解率 疾病控制率 无进展生存期 总生存期 

分 类 号：R734.2[医药卫生—肿瘤]