晚期肺腺癌患者维持治疗中EGFR-TKI联合贝伐珠单抗的回顾性分析

胡雪婷; 王康; 罗虎; 周向东

doi:10.16016/j.1000-5404.202011035

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晚期肺腺癌患者维持治疗中EGFR-TKI联合贝伐珠单抗的回顾性分析

临床医学 | 更新时间：2026-01-09

- 晚期肺腺癌患者维持治疗中EGFR-TKI联合贝伐珠单抗的回顾性分析
- EGFR-TKI plus bevacizumab as maintenance therapy for advanced lung adenocarcinoma: a retrospective study of 192 cases
- 第三军医大学学报 2021年43卷第7期页码：648-654
- 作者机构：
  
  400038 重庆, 陆军军医大学（第三军医大学）第一附属医院呼吸与危重症医学科
- 作者简介：
  
  [ 周向东，E-mail：xiangdongzhou@126.com ZHOU Xiangdong E-mail: xiangdongzhou@126.com
- 基金信息：
  
  国家自然科学基金青年科学基金(81702293);陆军军医大学临床医学科研人才培养计划项目(2019XLC1002)
- DOI：10.16016/j.1000-5404.202011035
  中图分类号： R730.53;R734.2;R979.1
- 收稿：2020-11-04，
  
  修回：2021-01-16，
  
  纸质出版：2021-04-15
- 稿件说明：
移动端阅览
胡雪婷, 王康, 罗虎, 等. 晚期肺腺癌患者维持治疗中EGFR-TKI联合贝伐珠单抗的回顾性分析[J]. 第三军医大学学报, 2021,43(7):648-654.

Xueting HU, Kang WANG, Hu LUO, et al. EGFR-TKI plus bevacizumab as maintenance therapy for advanced lung adenocarcinoma: a retrospective study of 192 cases[J]. Journal of Third Military Medical University, 2021, 43(7): 648-654.
胡雪婷, 王康, 罗虎, 等. 晚期肺腺癌患者维持治疗中EGFR-TKI联合贝伐珠单抗的回顾性分析[J]. 第三军医大学学报, 2021,43(7):648-654. DOI： 10.16016/j.1000-5404.202011035.

Xueting HU, Kang WANG, Hu LUO, et al. EGFR-TKI plus bevacizumab as maintenance therapy for advanced lung adenocarcinoma: a retrospective study of 192 cases[J]. Journal of Third Military Medical University, 2021, 43(7): 648-654. DOI： 10.16016/j.1000-5404.202011035.

摘要

目的

对比分析EGFR突变阳性的晚期肺腺癌患者经EGFR-TKI治疗达疾病稳定后联合贝伐珠单抗维持治疗与EGFR-TKI单药治疗的疗效与安全性。

方法

收集2013-2019年就诊于本院的192例晚期肺腺癌患者，其中联合组30例，单药组162例。联合组患者经一线EGFR-TKI诱导治疗后联合贝伐珠单抗维持治疗，单药组患者经一线EGFR-TKI治疗直至疾病进展。运用1∶1倾向性评分匹配共匹配29对患者。对比两组患者的总无进展生存期（progression-free survival，PFS1）、进入稳定期后的无进展生存期（PFS2）、持续缓解时间（duration of response，DoR）、客观缓解率（objective response rate，ORR）、肿瘤大小变化及安全性等。

结果

疗效方面：联合组较单药组中位PFS1、PFS2均明显延长，且差异有统计性意义，两组PFS1分别为17.3、11.5个月（

=0.401

=0.001），PFS2分别为6.0、3.9个月（

=0.527

=0.023)；联合组及单药组中位DoR分别为12.2、8.6个月，差异有统计学意义（

=0.503

=0.037）；两组ORR分别为79.3%、72.4%，差异无统计学意义，但联合组较单药组肿瘤距基线缩小的程度更大。安全性方面：两组均无治疗相关死亡事件发生；两组常见的不良反应为皮肤及黏膜损害（55%

62%）、肝功损害（55%

45%）、肾功能损害（17%

7%）、高血压（10%

0）；两组3/4级不良事件发生率分别为14%、7%，差异无统计学意义。

结论

EGFR-TKI联合贝伐珠单抗维持治疗的疗效优于EGFR-TKI单药治疗，且毒副作用无明显升高。

Abstract

Objective

To compare the efficacy and safety of EGFR-TKI plus bevacizumab as maintenance therapy with EGFR-TKI alone for EGFR-mutated advanced lung adenocarcinoma.

Methods

Clinical data of 192 patients with advanced lung adenocarcinoma admitted in our hospital from 2013 to 2019 were collected and retrospectively analyzed. Thirty of them received combination therapy (EGFR-TKI plus bevacizumab as maintenance therapy)

and the other 162 monotherapy (continuous treatment with EGFR-TKI until disease progression). Then 29 pairs of patients were matched by propensity score matching at a ratio of 1∶1. Overall progression-free survival (PFS1)

PFS after reaching stable disease (PFS2)

duration of response (DoR)

objective response rate (ORR)

tumor size changes and safety profiles were compared between the 2 groups.

Results

The combination group had significantly longer median PFS1 (17.3

11.5 months

=0.401

=0.001) and PFS2 (6.0

3.9 months

=0.527

=0.023)

and also statistically longer median DoR (12.2

8.6 months

=0.503

=0.037) when compared with the monotherapy group.The ORR was 79.3% and 72.4%

respectively

with no statistical difference but the reduction in target tumor lesion size was greater in the combination group. No treatment-associated death occurred in both groups. Common advance events were skin and mucous damage (55%

62%)

hepatic function damage (55%

45%)

renal function damage (17%

7%) and hypertension (10%

0). The rate of grade 3 or worse adverse events were 14% versus 7% in the 2 groups (

0.05).

Conclusion

EGFR-TKI plus bevacizumab is superior to EGFR-TKI monotherapy with more effective maintenance therapy and tolerable toxicity.

关键词

Keywords

references

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