程序性死亡因子受体-1抑制剂联合化疗和贝伐珠单抗一线治疗RAS突变MSS型晚期结直肠癌的疗效观察  

Clinical efficacy of PD-1 inhibitor combined with chemotherapy and bevacizumab as first-line treatment for advanced MSS colorectal cancer with RAS mutation

作　　者：孙子娟 汪海岩 施慧婕 司悦 SUN Zijuan;WANG Haiyan;SHI Huijie;SI Yue(The First Clinical College of Xuzhou Medical University,Xuzhou,Jiangsu 221000,China;Department of Oncology,The Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221000,China)

机构地区：[1]徐州医科大学第一临床学院,江苏徐州221000 [2]徐州医科大学附属医院肿瘤内科,江苏徐州221000

出　　处：《安徽医药》2024年第9期1850-1855,共6页Anhui Medical and Pharmaceutical Journal

摘　　要：目的评估程序性死亡因子受体-1(PD-1)抑制剂联合化疗和贝伐珠单抗一线治疗大鼠肉瘤病毒(RAS)基因突变、微卫星稳定(MSS)型晚期结直肠癌病人的疗效及安全性。方法2021年6月至2022年6月徐州医科大学附属医院收治的67例RAS基因突变MSS型晚期结直肠癌病人分为两组,观察组(n=32)行PD-1抑制剂联合化疗和贝伐珠单抗,对照组(n=35)行化疗联合贝伐珠单抗,观察两组的治疗效果及不良反应。结果观察组和对照组的客观缓解率(ORR)分别为78.1%和51.4%(P<0.05),疾病控制率(DCR)分别为96.9%和77.1%(P<0.05);观察组中位无进展生存期(mPFS)较对照组延长,分别为12.9个月和11.2个月,差异有统计学意义(P<0.05)。观察组的不良反应率高于对照组(90.6%比88.6%),差异无统计学意义(P>0.05),但均可控制,且未发生致死性事件。结论PD-1抑制剂联合化疗和贝伐珠单抗一线治疗RAS基因突变MSS型晚期结直肠癌初步显示疗效显著,此类病人在常规贝伐珠单抗联合化疗的基础上可以考虑加用PD-1抑制剂。Objective To evaluate the efficacy and safety of programmed death factor receptor-1(PD-1)inhibitor combined with chemotherapy and bevacizumab in first-line treatment of patients with advanced microsatellite-stable(MSS)colorectal cancer with RAS mutation.Methods A total of 67 patients with advanced MSS colorectal cancer wth RAS mutation admitted to The Affiliated Hospital of Xuzhou Medical University from June 2021 to June 2022 were assigned into two groups,the observation group(n=32)treated with PD-1 inhibitor combined with chemotherapy and bevacizumab,and the control group(n=35)treated with chemotherapy combined with bevacizumab.The efficacy and adverse reactions of the two groups were observed.Results The objective response rates(ORR)of the observation group and the control group were 78.1%and 51.4%,respectively(P<0.05),and the disease control rates(DCR)were 96.9%and 77.1%,respectively(P<0.05).The median progression free survival(mPFS)of the observation group was longer than that of the control group(12.9 months and 11.2 months,respectively),and the difference was statistically significant(P<0.05).The adverse reaction rate of the observation group was higher than that of the control group(90.6%vs.88.6%;P>0.05),but it could be controlled and no fatal event occurred.Conclusion PD-1 inhibitor combined with chemotherapy and bevacizumab in first-line treatment for advanced MSS colorectal cancer with RAS mutation showed initial significant efficacy,therefore PD-1 inhibitor can be added for such patients on the basis of conventional bevacizumab combined with chemotherapy.

关 键 词：结直肠肿瘤 微卫星稳定 大鼠肉瘤病毒基因突变 程序性死亡因子受体-1抑制剂 贝伐珠单抗 卡瑞利珠/信迪利 

分 类 号：R735.34[医药卫生—肿瘤]