塞来昔布在EGFR-TKI耐药性晚期NSCLC中对PD-1抑制剂的免疫增敏作用  

Immunosensitization of Celecoxib to PD-1 Inhibitors in EGFR-TKI-resistant Advanced NSCLC

作　　者：胡晟钊[1] 陈颖犁 黄绍芳 黄仕鹏[1] HU Shengzhao;CHEN Yingli;HUANG Shaofang;HUANG Shipeng(The First Affiliated Hospital of Nanchang University,Nanchang Jiangxi 330006,China;Jiangxi Children's Hospital,Nanchang Jiangxi 330006,China)

机构地区：[1]南昌大学第一附属医院,江西南昌330006 [2]江西省儿童医院,江西南昌330006

出　　处：《药品评价》2023年第3期303-306,共4页Drug Evaluation

基　　金：江西省卫生健康委科技计划(202210221)。

摘　　要：目的探究塞来昔布在EGFR-酪氨酸激酶抑制剂(EGFR-TKI)耐药性晚期非小细胞肺癌(NSCLC)中对程序性死亡分子-1(PD-1)抑制剂的免疫增敏作用。方法选择2020年12月至2022年1月在南昌大学第一附属医院进行治疗的晚期NSCLC患者82例,按随机数字表法分为对照组(n=41)、治疗组(n=41)。对照组采用TPC方案治疗,治疗组在对照组基础上联合塞来昔布治疗。观察两组临床疗效及不良反应,比较两组EGFR-T790M突变率及环氧化酶2(COX-2)蛋白表达。结果治疗组治疗有效率51.22%较对照组19.51%高(P<0.05)。治疗组EGFR-T790M突变率19.51%较对照组65.85%低(P<0.05)。治疗组COX-2阳性表达率24.39%较对照组60.98%低(P<0.05)。治疗组毒副作用发生率24.39%与对照组34.15%相比差异无统计学意义(P>0.05)。结论塞来昔布可明显提高NSCLC患者化疗敏感性,增强其临床疗效,且可改善EGFR-T790M突变状态。Objective To investigate the immune sensitizing effect of celecoxib on programmed death molecule-1(PD-1)inhibitors in EGFR-tyrosine kinase inhibitor(EGFR-TKI)-resistant advanced non-small cell lung cancer(NSCLC).Methods Eighty-two patients with advanced NSCLC who were treated at the First Affiliated Hospital of Nanchang University from December 2020 to January 2022 were selected,and 82 NSCLC patients were divided into control group(n=41)and treatment group(n=41)according to the random number table method.The control group was treated with TPC regimen,and the treatment group was treated with celecoxib on the basis of the control group.The clinical efficacy and adverse reactions of the two groups were observed,and the EGFR-T790M mutation rate and cyclooxygenase-2(COX-2)protein expression were compared between the two groups.Results The treatment efficiency of the treatment group was 51.22%significantly higher than that of the control group 19.51%(P<0.05).The EGFR-T790M mutation rate of 19.51%was significantly lower in the treatment group compared with 65.85%in the control group(P<0.05).The COX-2 positive expression rate of 24.39%in the treatment group was significantly lower than that of 60.98%in the control group(P<0.05).There was no statistically significant difference between the incidence of toxic side effects in the treatment group of 24.39%and that in the control group of 34.15%(P>0.05).Conclusion Celecoxib significantly improves chemotherapy sensitivity and clinical outcomes in NSCLC patients and improves EGFR-T790M mutation status.

关 键 词：塞来昔布 EGFR-TKI耐药 非小细胞肺癌 程序性死亡分子-1 

分 类 号：R734.2[医药卫生—肿瘤]