新辅助免疫联合化疗在非小细胞肺癌中的初步疗效观察  

Observation on the preliminary efficacy of neoadjuvant immunotherapy combined with chemotherapy in non-small cell lung cancer

作　　者：吴朝真 郑华[1] 盛舒言 张权[1] 张卉[1] 李杰[1] 吕嘉林[1] 钱哲[1] 王守正 李曦[1] 胡瑛[1] Wu Zhaozhen;Zheng Hua;Sheng Shuyan;Zhang Quan;Zhang Hui;Li Jie;Lyu Jialin;Qian Zhe;Wang Shouzheng;Li Xi;Hu Ying(The Second Department of Oncology,Beijing Chest Hospital,Capital Medical University,Beijing Tuberculosis and Thoracic Tumor Research Institute,the Second Oncology Department,Beijing 101149,China)

机构地区：[1]首都医科大学附属北京胸科医院/北京市结核病胸部肿瘤研究所肿瘤内二科,北京101149

出　　处：《首都医科大学学报》2024年第4期642-648,共7页Journal of Capital Medical University

基　　金：北京市卫健委重大项目(Feiai 2024-2)。

摘　　要：目的观察新辅助程序性死亡受体1(programmed receptor 1,PD-1)单抗免疫治疗联合化学药物治疗(以下简称化疗)在非小细胞肺癌(non-small cell lung cancer,NSCLC)中的近期疗效。方法纳入接受新辅助免疫联合化疗的IB~Ⅲ期NSCLC患者176例,之后159例(90.34%)患者接受手术治疗,包括腺癌42例、鳞癌115例和混合癌2例。结果所有患者接受新辅助治疗的中位周期数为2个周期,4例(2.5%)患者术前达到完全缓解(complete response,CR),115例(72.3%)患者达到部分缓解(partial response,PR),40例(25.2%)患者评估为疾病稳定(stable disease,SD)且仅有2例病灶增大;术后96例(60.4%,95%CI:52.7%~68.1%)患者达到显著病理缓解(major pathological response,MPR),74例(46.5%,95%CI:38.7%~54.4%)患者达到病理完全缓解(pathological complete response,pCR);多因素分析显示,性别和程序性死亡配体1(programmed ligand 1,PD-L1)显著影响MPR率和pCR率。结论新辅助免疫联合化疗在IB~Ⅲ期NSCLC治疗中初现疗效,PD-L1的表达水平可能是MPR和pCR的预测因素。Objective To evaluate the efficacy of neoadjuvant programmed receptor 1(PD-1)monoclonal antibody immunotherapy combined with chemotherapy for non-small cell lung cancer(NSCLC).Methods This study included 176 patients with stageⅠB~Ⅲresectable NSCLC who received neoadjuvant immunotherapy combined with chemotherapy at our research center from January 2021 to December 2023.Totally,159 patients(90.34%)received surgical treatment,including 42 cases of adenocarcinoma and 115 cases of squamous cell carcinoma.Results The median number of neoadjuvant treatment cycles was 2,with 4 patients(2.5%)achieving complete response(CR),115 patients(72.3%)achieving partial response(PR),and 40 patients(25.2%)assessed as stable disease(SD)with only 2 cases of tumor enlargement;After surgery,96 patients(60.4%,95%CI:52.7%-68.1%)achieved major pathological response(MPR),and 74 patients(46.5%,95%CI:38.7%-54.4%)achieved pathological complete response(pCR);Multivariate analysis showed that gender and programmed ligand 1(PD-L1)significantly influenced the rates of MPR and pCR.Conclusion Neoadjuvant immunotherapy combined with chemotherapy showed initial efficacy in resectable stageⅠB~ⅢNSCLC,and the expression level of PD-L1 may be a predictive factor for MPR and pCR.

关 键 词：新辅助化疗 PD-1单抗 非小细胞肺癌 疗效 

分 类 号：R734.2[医药卫生—肿瘤]