Prognosis and Safety of Programmed Death 1 Inhibitors in First-Line Treatment of Advanced Non-Small Cell Lung Cancer

ZUO Gang; WANG Genhe; FANG Ping

doi:10.14009/j.issn.1672-2124.2022.11.013

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Prognosis and Safety of Programmed Death 1 Inhibitors in First-Line Treatment of Advanced Non-Small Cell Lung Cancer

更新时间：2023-04-16

- Prognosis and Safety of Programmed Death 1 Inhibitors in First-Line Treatment of Advanced Non-Small Cell Lung Cancer
- Issue 11, Pages: 1340-1344(2022)
- 作者机构：
  
  黄山市人民医院肿瘤内科
- 作者简介：
- 基金信息：
- DOI：10.14009/j.issn.1672-2124.2022.11.013
  CLC： R734.2
- Published：2022，
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ZUO Gang, WANG Genhe, FANG Ping. Prognosis and Safety of Programmed Death 1 Inhibitors in First-Line Treatment of Advanced Non-Small Cell Lung Cancer. [J]. (11):1340-1344(2022)
DOI：

ZUO Gang, WANG Genhe, FANG Ping. Prognosis and Safety of Programmed Death 1 Inhibitors in First-Line Treatment of Advanced Non-Small Cell Lung Cancer. [J]. (11):1340-1344(2022) DOI： 10.14009/j.issn.1672-2124.2022.11.013.

摘要

目的：探讨程序性死亡受体1（PD-1）抑制剂作为一线治疗晚期非小细胞肺癌（NSCLC）方案的预后及安全性。方法：收集2019年5月至2021年1月该院采用3种PD-1抑制剂（卡瑞利珠单抗、信迪利单抗和替雷利珠单抗）作为一线治疗的90例晚期NSCLC患者的临床资料，回顾性分析患者的临床特征和不良反应，比较临床特征对PD-1抑制剂一线治疗晚期NSCLC的疾病控制率（DCR）、无进展生存期（PFS）的影响。结果：所有患者的客观缓解率为54.4%（49/90）

DCR为78.9%（71/90）

多因素分析结果显示，Ⅲb和Ⅲc期、联合化疗及PD-1阳性为影响晚期NSCLC的DCR保护因素（P＜0.05）。随访观察中，90例患者的中位PFS为8.6个月；COX回归结果显示，Ⅲb和Ⅲc期、联合化疗及PD-1阳性是晚期NSCLC的PFS保护因素，Ⅲb和Ⅲc期（中位PFS:11.0个月vs. 7.2个月，χ~2=4.152

P=0.042）、联合化疗（中位PFS:9.6个月vs. 7.6个月，χ~2=4.066

P=0.044）及PD-1阳性（中位PFS:10.9个月vs. 6.6个月，χ~2=13.978

P＜0.001）患者有较长的PFS。患者总不良反应发生率为67.8%（61/90）

使用卡瑞利珠单抗、信迪利单抗和替雷利珠单抗患者的不良反应发生率分别为75.0%（21/28）、73.3%（22/30）和56.3%（18/32）

组间差异无统计学意义（χ~2=3.041

P=0.218）。结论：PD-1抑制剂作为一线治疗方案治疗晚期NSCLC患者具有较好的临床价值，但应注意治疗过程中的不良反应。Ⅲb和Ⅲc期、PD-L1阳性的晚期NSCLC患者使用PD-1抑制剂的临床效果较好，同时采用PD-1联合化疗患者收益更佳。

Abstract

OBJECTIVE: To probe into the prognosis and safety of programmed death 1（PD-1） inhibitors in first-line treatment of advanced non-small cell lung cancer（NSCLC）. METHODS: Clinical data of 90 patients with advanced NSCLC treated with three kinds of PD-1 inhibitors（camrelizumab

sintilizumab and tislelizumab） as first-line treatment in the hospital from May 2019 to Jan. 2021 were collected. Clinical characteristics and adverse drug reactions were retrospectively analyzed

and the effects of clinical characteristics on disease control（DCR） and progression-free survival（PFS） of advanced NSCLC treated with PD-1 inhibitors as first-line treatment were compared. RESULTS: The objective response rate（ORR） of all patients was 54.4%（49/90）

and the DCR was 78.9%（71/90）. Multivariate analysis showed that Ⅲb and Ⅲc

combined chemotherapy and PD-1 positive were the protective factors for DCR in advanced NSCLC（P<0.05）. In follow-up observation

the median PFS of 90 patients was 8.6 months. COX regression analysis showed that s Ⅲb and Ⅲc

combined chemotherapy and PD-1 positive were the protective factors of PFS in advanced NSCLC. Ⅲb and Ⅲc（median PFS:11.0 months vs. 7.2 months

χ~2=4.152

P=0.042）

combined chemotherapy（median PFS:9.6 months vs. 7.6 months

χ~2=4.066

P=0.044） and PD-1 positive（median PFS:10.9 months vs. 6.6 months

χ~2=13.978

P<0.001） patients had longer PFS. The overall incidence of adverse drug reactions was 67.8%（61/90）. The incidences of adverse drug reactions of camrelizumab

sintilide and tislelizumab were respectively 75.0%（21/28）

73.3%（22/30） and 56.3%（18/32）

there was no significant difference among three groups（χ~2=3.041

P=0.218）. CONCLUSIONS: PD-1 inhibitors have good clinical value as the first-line treatment for patients with advanced NSCLC

yet attention should be paid to adverse drug reactions during treatment. The clinical effect of PD-1 inhibitor is better for advanced NSCLC patients with Ⅲb and Ⅲc

and PD-L1 positive

and patients treated with PD-1 combined with chemotherapy have better benefits.

关键词

非小细胞肺癌程序性死亡受体1预后疗效

Keywords

Non-small cell lung cancerProgrammed death 1PrognosisEfficacy

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