程序性死亡受体-1抑制剂联合化疗一线治疗程序性死亡受体配体1高表达晚期非小细胞肺癌疗效分析  

Clinical efficacy of programmed death 1 inhibitor combined with chemotherapy in the first-line treatment of advanced non-small cell lung cancer with high expression of programmed death-ligand 1

作　　者：段芦博 刘亚清 陈飞帆 李一鑫 王丽萍[1] DUAN Lubo;LIU Yaqing;CHEN Feifan;WANG Liping(Department of Oncology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院肿瘤科,河南郑州450052

出　　处：《肿瘤基础与临床》2023年第6期472-476,共5页journal of basic and clinical oncology

基　　金：国家自然科学基金面上项目(81872410)。

摘　　要：目的探讨程序性死亡受体-1(PD-1)抑制剂联合化疗一线治疗细胞程序性死亡受体配体1(PD-L1)高表达晚期非小细胞肺癌的疗效。方法回顾性分析2020年6月至2022年3月郑州大学第一附属医院收治的64例驱动基因阴性且PD-L1高表达晚期非小细胞肺癌患者的临床资料。观察组32例患者接受PD-1抑制剂联合化疗治疗,对照组32例患者接受PD-1抑制剂单药治疗。比较2组疗效和不良反应。结果观察组和对照组总有效率、疾病控制率比较差异均无统计学意义(χ^(2)=1.036,P=0.309;χ^(2)=0.736,P=0.391)。观察组和对照组中位疾病无进展生存时间分别为8.78个月和5.00个月(χ^(2)=4.046,P=0.044)。观察组骨髓抑制总发生率高于对照组(χ^(2)=9.328,P=0.002)。观察组Ⅲ、Ⅳ度骨髓抑制、消化道反应发生率均高于对照组(χ^(2)=11.852,P=0.001;χ^(2)=4.010,P=0.045)。结论PD-1抑制剂联合化疗一线治疗PD-L1高表达晚期非小细胞肺癌安全有效,能够延长患者疾病无进展生存时间。Objective To explore the efficacy of programmed death 1(PD-1)inhibitor combined with chemotherapy in the first-line treatment of advanced non-small cell lung cancer with high expression of programmed death-ligand 1(PD-L1).Methods The clinical data of 64 cases of advanced non-small cell lung cancer with negative driver gene and high expression of PD-L1 admitted to the First Affiliated Hospital of Zhengzhou University from June 2020 to March 2022 were retrospectively analyzed.The 32 patients in the observation group received PD-1 inhibitor combined with chemotherapy,and the 32 patients in the control group received PD-1 inhibitor monotherapy.The difference of efficacy and adverse reactions between the two groups was compared.Results There was no significant difference in the overall response rate and the disease control rate between the observation group and the control group(χ^(2)=1.036,P=0.309;χ^(2)=0.736,P=0.391).The median progression-free survival of the observation group and the control group were 8.78 months and 5.25 months,and the difference was statistically significant(χ^(2)=4.046,P=0.044).The overall incidence of bone marrow suppression in the observation group was higher than that in the control group,and the difference was statistically significant(χ^(2)=9.328,P=0.002).The gradeⅢandⅣincidences of bone marrow suppression and gastrointestinal reactions in the observation group were higher than those in the control group,and the differences were statistically significant(χ^(2)=11.852,P=0.001;χ^(2)=4.010,P=0.045).Conclusion In the first line treatment,PD-1 inhibitor combined with chemotherapy can prolong the progression free survival time of advanced non-small cell lung cancer with high expression of PD-L1,and the overall adverse reactions can be controlled.

关 键 词：非小细胞肺癌 免疫检查点抑制剂 免疫治疗 安全性 

分 类 号：R734.2[医药卫生—肿瘤]