Efficacy and short-term survival of PD-1 immunotherapy combined with bevacizumab for double-target anti-angiogenic therapy on stageⅣlung adenocarcinoma and its influence on cellular immune function
Wu Renhua. Efficacy and short-term survival of PD-1 immunotherapy combined with bevacizumab for double-target anti-angiogenic therapy on stageⅣlung adenocarcinoma and its influence on cellular immune function[J]. Journal of Chongqing Medical University, 2021,46(8):882-887.
Wu Renhua. Efficacy and short-term survival of PD-1 immunotherapy combined with bevacizumab for double-target anti-angiogenic therapy on stageⅣlung adenocarcinoma and its influence on cellular immune function[J]. Journal of Chongqing Medical University, 2021,46(8):882-887. DOI: 10.13406/j.cnki.cyxb.002878.
目的: 观察程序性细胞死亡因子1(programmed cell death 1,PD-1)免疫治疗联合贝伐单抗进行抗血管生成双靶治疗Ⅳ期肺腺癌的疗效,并分析其对细胞免疫功能、短期预后和不良反应的影响。方法: 选取成都大学附属医院2018年12月至2020年8月收治的Ⅳ期肺腺癌患者67例,按照治疗方式不同分为对照组(n=33)和联合组(n=34),对照组予以化疗+PD-1抑制剂治疗,联合组予以化疗+PD-1抑制剂+贝伐单抗治疗,比较2组患者近期治疗疗效、治疗前后细胞免疫功能、卡氏功能状态(Karnofsky performance status,KPS)评分变化情况、不良反应及无进展生存期。结果: 联合组患者治疗总有效率和疾病控制率分别为29.41%和79.41%,显著高于对照组的9.09%和54.55%(P<0.05);治疗后,联合组患者CD3+、CD4+、CD4+/CD8+显著高于对照组(P<0.05),CD8+与对照组患者比较无统计学差异(P>0.05);联合组患者KPS评分增加稳定率为73.53%,显著高于对照组患者的45.45%(P<0.05);联合组患者骨髓抑制、消化道反应、血液毒性、肝肾功能损害及周围神经毒性不良反应发生率与对照组患者比较,差异无统计学意义(P>0.05);联合组患者中位无进展生存期为9.73个月,对照组患者中位无进展生存期为6.05个月,差异有统计学意义(P<0.05)。结论: 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,可明显提高近期治疗疗效,改善患者免疫功能,提高其生存质量,延长其无进展生存时间。
Abstract
Objective: To observe the efficacy of programmed cell death 1 (PD-1) immunotherapy combined with bevacizumab for double-target anti-angiogenic therapy on stageⅣlung adenocarcinoma
and to analyze its influence on cellular immune function
short-term prognosis and adverse reactions. Methods: A total of 67 patients with stageⅣlung adenocarcinoma admitted to our hospital between December 2018 and August 2020 were selected in this study and they were divided into control group (n=33) and combined group (n=34) according to different treatment methods. Control group were treated with chemotherapy+PD-1 inhibitor
and combined group were treated with chemotherapy+PD-1 inhibitor+bevacizumab. The short-term treatment efficacy
changes of cellular immune function and Karnofsky performance status (KPS) score before and after treatment
adverse reactions and progression-free survival time were compared between the two groups. Results: The total effective rate of treatment and disease control rate of combined group were 29.41%and 79.41%respectively
which were significantly higher than 9.09%and 54.55%of control group (P<0.05). After treatment
the CD3+
CD4+and CD4+/CD8+in combined group were significantly higher than those in control group (P<0.05)
and there was no significant difference in CD8+compared to control group (P>0.05). The increase and stable rate of KPS score of patients in combined group was significantly higher than that in control group (73.53%vs.45.45%) (P<0.05). There were no significant differences in the incidence of adverse reactions such as bone marrow suppression
gastrointestinal reactions
blood toxicity
liver-kidney functional damage and peripheral neurotoxicity in combined group compared with those in control group (P>0.05). The median progression-free survival time were 9.73 months in combined group and were 6.05 months in control group
with significant differences (P<0.05). Conclusion: PD-1 immunotherapy combined with bevacizumab for double-target anti-angiogenic therapy of stageⅣlung adenocarcinoma can significantly enhance the short-term treatment efficacy
improve the immune function
promote the quality of life and prolong the progression-free survival time.
关键词
程序性细胞死亡因子1肿瘤微环境免疫治疗抗血管生成非小细胞肺癌免疫功能生存预后
Keywords
programmed cell death 1tumor microenvironmentimmunotherapyanti-angiogenesisnon-small cell lung cancerimmune functionsurvival prognosis