PD-1/PD-L1抑制剂联合含铂方案化疗治疗晚期三阴性乳腺癌的疗效  

Effect of PD-1/PD-L1 inhibitors combined with platinum chemotherapy in the treatment of advanced triple-negative breast cancer

作　　者：杨蕙嘉 任章霞 顾洪 王颖 罗凤梅[3] YANG Huijia;REN Zhangxia;GU Hong;WANG Ying;LUO Fengmei(Department of Thyroid and Breast Surgery,West China Guang'an Hospital,Sichuan University,Guang'an 638000,Sichuan,China;Department of Oncology,West China Guang'an Hospital,Sichuan University,Guang'an 638000,Sichuan,China;Department of General Surgery,Yuechi People's Hospital,Guang'an 638300,Sichuan,China)

机构地区：[1]四川大学华西广安医院甲乳外科,四川广安638000 [2]四川大学华西广安医院肿瘤内科,四川广安638000 [3]岳池县人民医院普外科,四川广安638300

出　　处：《西部医学》2024年第5期719-722,727,共5页Medical Journal of West China

基　　金：广安市科技创新项目(2020SYF03)。

摘　　要：目的探讨程序性细胞死亡蛋白-1(PD-1)/程序性细胞死亡配体-1(PD-L1)抑制剂联合含铂方案化疗治疗晚期三阴性乳腺癌(TNBC)的疗效及对3年生存率的影响。方法回顾性收集2016年4月—2019年8月四川大学华西广安医院收治的90例晚期TNBC患者的病历资料,根据最终选取的治疗方案分为观察组47例和对照组43例。对照组使用吉西他滨、顺铂和常规治疗方案,观察组在对照组的基础上,联合使用帕博利珠单抗注射液。比较两组患者治疗前后血清肿瘤标志物水平、治疗后临床疗效、不良反应发生率和3年生存率。结果治疗前,两组晚期TNBC患者肿瘤标志物水平无显著性差异(P>0.05);治疗后,观察组血清癌胚抗原(CEA)、糖类抗原199(CA199)和糖类抗原125(CA125)明显低于对照组(P<0.05);观察组病情缓解率(ORR)和病情控制率(DCR)显著高于对照组(P<0.05);两组患者不良反应发生率和3年生存率无显著性差异(P>0.05)。结论PD-1/PD-L1抑制剂联合含铂方案化疗治疗晚期TNBC,可有效改善疗效和血清肿瘤标志物水平,安全性高,为临床使用PD-1/PD-L1抑制剂治疗晚期TNBC提供了一定的参考依据。Objective To explore the curative effect of programmed cell death protein-1(PD-1)/programmed cell death ligand-1(PD-L1)inhibitors combined with platinum chemotherapy on advanced triple-negative breast cancer(TNBC)and the influences on 3-year survival rate.Methods A retrospective collection was performed on case data of 90 patients with advanced TNBC admitted to the hospital from April 2016 to August 2019.According to the final treatment methods,they were divided into observation group(n=47)and control group(n=43).The control group was given gemcitabine,cisplatin chemotherapy and routine treatment,while observation group was additionally given Pembrolizumab injection.The levels of serum tumor markers before and after treatment,clinical curative effect,incidence of adverse reactions and 3-year survival rate after treatment were compared between the two groups.Results Before treatment,there was no significant difference between the two groups in levels of tumor markers(P>0.05).After treatment,levels of serum carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199)and carbohydrate antigen 125(CA125)in observation group were significantly lower than those in control group(P<0.05),objective remission rate(ORR)and disease control rate(DCR)were significantly higher than those in control group(P<0.05).There was no significant difference in the incidence of adverse reactions or 3-year survival rate between the two groups(P>0.05).Conclusion PD-1/PD-L1 inhibitors combined with platinum chemotherapy can effectively improve curative effect and levels of serum tumor markers in advanced TNBC,with high safety.And it provides certain reference for the clinical usage of PD-1/PD-L1 inhibitors in the treatment of advanced TNBC.

关 键 词：PD-1/PD-L1抑制剂 铂类化疗药物 晚期三阴性乳腺癌 疗效 3年生存率 

分 类 号：R737.9[医药卫生—肿瘤]