纳武利尤单抗联合培美曲塞治疗晚期NSCLC对患者疗效及预后的影响

摘要
图/表
参考文献
相关文章 (8)

全文: PDF (1872 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要 目的：分析程序性死亡受体-1（programmed death receptor-1,PD-1）/程序性死亡受体配体-1（programmed death receptor ligand-1,PD-L1）抑制剂纳武利尤单抗联合培美曲塞治疗晚期非小细胞肺癌（non-small cell lung cancer,NSCLC）的疗效及对预后的影响。方法：招募2018年1月―2021年1月我院收治的98例晚期NSCLC患者,按随机数字表法分为观察组（49例,培美曲塞+纳武利尤单抗治疗）与对照组（49例,培美曲塞治疗）,两组患者均连续用药到出现不耐受或疾病进展。记录两组治疗后（2个化疗周期）临床疗效、治疗期间不良反应,比较治疗前、后两组免疫功能（CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺）、血清相关因子[血清前梯度蛋白2（recombinant anterior gradient protein 2,AGR2）、金属基质蛋白酶-9（matrix metalloprotein-9,MMP-9）]、生活质量[Karnofsky评分（KPS评分）]水平。结果：2个化疗周期内两组均无死亡病例,观察组临床客观缓解率（objetive response rate,ORR）（57.14%）显著高于对照组（36.73%）,治疗前后CD3⁺、CD8⁺、AGR2、MMP-9、KPS评分差值绝对值显著大于对照组,CD4⁺、CD4⁺/CD8⁺差值绝对值显著小于对照组。两组不良反应无显著差异,出现症状患者经下调药物剂量25%~50%及对症处理后耐受良好,可控。结论：纳武利尤单抗联合培美曲塞治疗晚期NSCLC可提高短期缓解效果,增强患者机体免疫功能,提高生活质量,未明显增加不良反应发生率。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	黄晓丽
	王琳
	杨婷
	罗丽莎
	周怡
	杨溢
	马利红

关键词 ： NSCLC, PD-1/PD-L1, 培美曲塞, 免疫功能, 生活质量

Abstract：Objective To analyze the efficacy of programmed death receptor-1(PD-1) /programmed death receptor ligand-1(PD-L1) inhibitor nivolumab combined with pemetrexed in the treatment of advanced non-small cell lung cancer (NSCLC) and its effects on prognosis. Method A total of 98 patients with advanced NSCLC treated in the hospital from January 2018 to January 2021 were recruited and divided into observation group (49 cases, pemetrexed+ nivolumab) and control group (49 cases, pemetrexed) by the random number table method. Both groups of patients were continuously treated until intolerance or disease progression occurred. The clinical efficacy after treatment (2 cycles of chemotherapy) and adverse reactions during treatment in the two groups were recorded. The immune function (CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺), serum related factors [serum recombinant anterior gradient protein 2(AGR2), matrix metalloproteinase-9(MMP-9) ] and quality of life [Karnofsky Performance Status (KPS score) ] were compared between the two groups before and after treatment. Results There were no deaths in both groups within 2 cycles of chemotherapy, and the clinical objective response rate (ORR) of 57.14% in observation group was significantly higher than 36.73% in control group, and the absolute difference values of CD3⁺, CD8⁺, AGR2, MMP-9 and KPS score before and after treatment were significantly higher than those in control group while the absolute difference values of CD4⁺and CD4⁺/CD8⁺were significantly lower than those in control group. There were no significant differences in the adverse reactions between the two groups, and the patients with symptoms were well tolerated and controlled by 25%~50% down-regulated dose and symptomatic treatment. Conclusion Nivolumab combined with pemetrexed in the treatment of advanced NSCLC can improve the short-term relief effect, strengthen the body's immune function and enhance the quality of life, and it does not significantly increase the incidence rates of adverse reactions.

Key words： NSCLC PD-1/PD-L1 pemetrexed immune function quality of life

收稿日期: 2023-04-14

中图分类号:

R734.2

基金资助:成都市卫生健康委员会科研课题（编号：2022110）

通讯作者: 马利红,E-mail：173360450@qq.com

引用本文:

黄晓丽, 王琳, 杨婷, 罗丽莎, 周怡, 杨溢, 马利红. 纳武利尤单抗联合培美曲塞治疗晚期NSCLC对患者疗效及预后的影响[J]. 金宝搏官方188学报(医学版), 2023, 20(3): 43-46. HUANG Xiaoli, WANG Lin, YANG Ting, LUO Lisha, ZHOU Yi, YANG Yi, MA Lihong. Effects of nivolumab combined with pemetrexed on efficacy and prognosis in the treatment of advanced NSCLC. HuNan ShiFan DaXue XueBao(YiXueBan), 2023, 20(3): 43-46.

链接本文:

http://yxb.hunnu.edu.cn/CN/ 或 http://yxb.hunnu.edu.cn/CN/Y2023/V20/I3/43

[1] 邱海波, 曹素梅, 徐瑞华. 基于2020年全球流行病学数据分析中国癌症发病率、死亡率和负担的时间趋势及与美国和英国数据的比较[J]. 癌症, 2022, 41(4): 165-177.
[2] Sung H, Ferlay J, Siegel RL, et al.Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries[J]. CA Cancer J Clin, 2021, 71(3): 209-249.
[3] 高娜, 王崇宝. 胸腺肽联合顺铂、培美曲塞二钠治疗晚期非小细胞肺癌临床疗效研究[J]. 陕西医学杂志, 2022, 51(11): 1424-1427.
[4] Chen P, Liu Y, Wen Y, et al.Non-small cell lung cancer in China[J]. Cancer Commun (Lond), 2022, 42(10): 937-970.
[5] Reck M, Remon J, Hellmann MD.First-Line Immunotherapy for Non-Small-Cell Lung Cancer[J]. J Clin Oncol, 2022, 40(6): 586-597.
[6] 王燕, 庞雅琪, 许新华. PD-1/PD-L1基因多态性在非小细胞肺癌中的研究进展[J]. 实用医学杂志, 2022, 38(12): 1470-1474.
[7] 张军艳, 谷俊. 程序性死亡配体1在肺癌组织中的表达及其与患者病理特征和疾病预后相关性研究[J]. 陕西医学杂志, 2022, 51(7): 894-897.
[8] 王佳慧, 陈公琰. 基于PD-1/PD-L1抑制剂的非小细胞肺癌免疫治疗预测标志物的研究进展[J]. 现代肿瘤医学, 2021, 29(10): 1822-1825.
[9] 田甜, 唐苏丹. 血小板/淋巴细胞比值与PD-1/PD-L1抑制剂治疗非小细胞肺癌患者预后关系的Meta分析[J]. 肿瘤防治研究, 2021, 48(6): 611-616.
[10] 邱鲁鹏, 赵晓, 刘茗露, 等. PD-1/PD-L1抑制剂联合抗血管生成药物治疗晚期非小细胞肺癌的临床观察[J]. 临床肿瘤学杂志, 2022, 27(5): 411-418.
[11] 方媛, 王宇立, 徐静, 等. 扶正祛邪方联合肿瘤深部热疗治疗晚期肺癌的临床观察[J]. 辽宁中医杂志, 2021, 48(2): 104-106.
[12] 翟素平, 张成辉, 马昕炜. 肿瘤标志物及T淋巴细胞亚群在肺癌化疗患者中的变化及临床意义[J]. 癌症进展, 2021, 19(16): 1678-1681+1689.
[13] 邬仁华, 卿毅, 李林, 等. PD-1免疫治疗联合贝伐单抗进行抗血管生成双靶治疗Ⅳ期肺腺癌疗效, 短期生存及对细胞免疫功能的影响[J]. 重庆医科大学学报, 2021, 46(8): 882-887.
[14] 陈香梅, 刘太锋, 杨明, 等. 复方苦参注射液联合化疗治疗非小细胞肺癌疗效研究[J]. 陕西中医, 2021, 42(12): 1700-1702.
[15] 王为民, 王宏志, 王云, 等. 淋巴细胞亚群检测在晚期肺癌化疗中的意义[J]. 临床和实验医学杂志, 2021, 20(12): 1260-1263.
[16] 郑颖妮, 黄琦, 周艳华. 阿法替尼靶向治疗与培美曲塞联合顺铂治疗表皮生长因子受体突变晚期非小细胞肺癌的临床疗效[J]. 癌症进展, 2022, 20(2): 170-173.
[17] 车啸天, 郁翰. 以培美曲塞为基础的维持治疗对局部晚期和转移性肺癌生存率的影响[J]. 中国肿瘤临床与康复, 2022, 29(9): 1063-1065.
[18] 王芸, 王郁阳, 姜曼, 等. 帕博利珠单抗对晚期非小细胞肺癌患者T淋巴细胞亚群的影响及疗效观测[J]. 中国肺癌杂志, 2021, 24(3): 182-187.
[19] 张红军, 陆婉玲. 纳武利尤单抗注射液治疗非小细胞肺癌的安全性及对患者免疫功能的影响[J]. 现代肿瘤医学, 2022, 30(22): 4097-4101.
[20] 沈丹, 冯平, 周静, 等. 纳武利尤单抗联合培美曲塞治疗老年Ⅲb~Ⅳ期非小细胞肺癌的效果及对患者血清TGF-β1与VEGF表达的影响[J]老年医学与保健, 2021, 027(6): 1156-1159.
[21] 林国强, 张彦明, 康立清, 等. PD-L1过表达对CLL-1CAR-T细胞抗急性髓系白血病作用的影响[J]. 中华血液学杂志, 2020, 41(10): 7.
[22] 黄育刚, 王莉, 汤显斌. PD-1/PD-L1免疫抑制剂在肺癌临床治疗和病理检测中的研究进展[J]. 临床与实验病理学杂志, 2020, 36(6): 5688-5692.
[23] 张利诚, 黄良龙, 黄宽. 参一胶囊联合化疗对中晚期非小细胞肺癌患者近期疗效及血清NKG2D, IFN-γ, IL-2水平和T淋巴细胞亚群的影响[J]. 中国老年学杂志, 2020, 40(11): 2296-2299.
[24] Pan B, Wei ZX, Zhang JX, et al.The value of AGR2 and KRT5 as an immunomarker combination in distinguishing lung squamous cell carcinoma from adenocarcinoma[J]. Am J Transl Res, 2021, 13(5): 4464-4476.
[25] 戴月梅, 王星圆, 加孜那·托哈依. 长链非编码RNA-LINC01296与肺癌细胞上皮间质转化的关系研究[J]. 新疆医科大学学报, 2022, 45(9): 953-957.