卡瑞利珠单抗、阿帕替尼联合卡培他滨二线治疗晚期三阴性乳腺癌的临床研究  

Clinical study of carrilizumab,Apatinib combined with capecitabine in second-line treatment of advanced triple-negative breast cancer

作　　者：郭丽芳[1] 李敏[1] 李银英[1] 赵蓉爽 杨红梅 GUO Li-fang;LI Min;LI Yin-ying;ZHAO Rong-shuang;YANG Hong-mei(Department of Pharmacy,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA;Department of Oncology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA;Breast Department,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA)

机构地区：[1]郑州大学第二附属医院药学部,河南郑州450000 [2]郑州大学第二附属医院肿瘤科,河南郑州450000 [3]郑州大学第三附属医院乳腺科,河南郑州450000

出　　处：《海南医学》2024年第6期777-781,共5页Hainan Medical Journal

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20210230)。

摘　　要：目的探究卡瑞利珠单抗、阿帕替尼联合卡培他滨二线治疗晚期三阴性乳腺癌的临床效果。方法前瞻性选取2020年1月至2022年1月郑州大学第二附属医院收治的122例晚期三阴性乳腺癌患者纳入研究,按随机数表法分为观察组和对照组各61例,对照组患者采用阿帕替尼+卡培他滨二线治疗,观察组患者在对照组治疗的基础上联合卡瑞利珠单抗治疗。一个疗程21 d,治疗2个疗程。治疗2个疗程后,比较两组患者的临床疗效,以及治疗前后的肿瘤标志物水平[糖类抗原15-3(CA15-3)、癌胚抗原(CEA)]和免疫功能,同时比较两组患者治疗期间的药物不良反应。随访1年,比较两组患者的生存情况。结果观察组患者的客观缓解率和疾病控制率分别为59.02%、81.97%,明显高于对照组的39.34%、65.57%,差异均有统计学意义(P<0.05);治疗前,两组患者的血清CA15-3、CEA水平比较差异均无统计学意义(P>0.05),治疗后,两组患者的血清CA15-3、CEA水平均降低,且观察组明显低于对照组,差异均有统计学意义(P<0.05);治疗后,两组患者的CD3+、CD8+水平均升高,且观察组明显高于对照组,治疗后,两组患者的CD4+均降低,且观察组明显低于对照组,差异均有统计学意义(P<0.05);两组患者治疗期间的不良反应发生率比较差异均无统计学意义(P>0.05)。随访1年,观察组失访1例,对照组失访2例,观察组患者的中位无进展生存时间为11.55个月,明显长于对照组的6.98个月,差异有统计学意义(P<0.05)。结论卡瑞利珠单抗、阿帕替尼联合卡培他滨二线治疗晚期三阴性乳腺癌,可有效调节患者的肿瘤标志物,提高客观缓解率,促进免疫功能的恢复、延长患者的生存期且安全性良好。Objective To explore the clinical effect of carrilizumab,Apatinib combined with capecitabine in second-line treatment of advanced triple-negative breast cancer.Methods A total of 122 patients with advanced triple-negative breast cancer who were admitted to the Second Affiliated Hospital of Zhengzhou University from January 2020 to January 2022 were prospectively selected and divided into an observation group and a control group according to random number table method,with 61 cases in each group.Patients in the control group received second-line treatment with Apatinib+capecitabine,and the observation group received carrilizumab on the basis of the treatment in the control group,with 21 days as a course of treatment,for 2 courses.After treatment,the clinical curative effect were compared between the two groups,as well as tumor markers[carbohydrate antigen 15-3(CA15-3),carcinoembryonic antigen(CEA)],immune function,and adverse drug reactions before and after 2 courses of treatment.The patients were followed up for 1 year and their survival was recorded.Results The objective remission rate and disease control rate of the observation group were 59.02%and 81.97%,respectively,which were significantly higher than 39.34%and 65.57%of control group(P<0.05).Before treatment,there was no statistically significant differences in serum CA15-3 and CEA levels between the two groups(P>0.05);after treatment,serum CA15-3 and CEA levels in the two groups were significantly decreased,and the levels in the observation group were significantly lower than those in the control group;the differences were statistically significant(P<0.05).The levels of CD3+and CD8+in both groups were significantly indoicreased,and the levels in the observation group were significantly higher than those in the control group,with statistically significant differences(P<0.05).After treatment,CD4+in both groups was significantly decreased(P<0.05),and the level in the observation group was significantly lower,with statistically significant differences(P<0.05).T

关 键 词：晚期三阴性乳腺癌 癌胚抗原 卡瑞利珠单抗 卡培他滨 免疫功能 生存期 疗效 

分 类 号：R737.9[医药卫生—肿瘤]