收稿日期: 2023-04-27
网络出版日期: 2023-09-26
基金资助
国家自然科学基金项目(82003304);广东省自然科学基金项目(2022A1515012400)
Efficacy and safety of chemotherapy plus immunotherapy and recombinant human endostatin in treating advanced non-small cell lung cancer
Received date: 2023-04-27
Online published: 2023-09-26
目的 评估化疗联合免疫及重组人血管内皮抑制素（恩度）治疗晚期非小细胞肺癌（non-small cell lung cancer， NSCLC）的疗效及安全性。 方法 回顾性分析了2020年6月至 2022年12月在广州市胸科医院接受化疗联合免疫及恩度治疗的24例晚期NSCLC患者。主要观察终点为无进展生存期（PFS）和客观缓解率（ORR），次要观察终点为疾病控制率（DCR）及不良反应事件（AEs）。 结果 中位随访19.2个月时，中位PFS（mPFS）为11个月（95%CI 8.722 ~ 13.278）。17例接受一线治疗的mPFS为11个月（95%CI 9.782 ~ 12.218）。6个月和12个月的PFS率分别为82.4%和52.9%，且一线治疗的ORR为58.8%，DCR为94.1%。17例一线治疗的患者中有2例（11.8%）发生了3 - 4级AEs，其中以血液毒性最常见。17例患者中有8例（47.1%）发生1 - 2级AEs，其中最常见的是血液毒性（17.6%）、皮肤瘙痒（17.6%）和肝毒性（5.9%）。 结论 化疗联合免疫及恩度治疗NSCLC有良好的疗效和可控的安全性。
关键词： 肺癌; 非小细胞; 化疗; 免疫治疗; 重组人血管内皮抑制素
张贤兰 , 朱玉斐 , 曾云云 , 黄智昊 , 岑文昌 , 苏珊 . 化疗联合免疫及重组人血管内皮抑制素治疗晚期非小细胞肺癌的有效性及安全性分析[J]. 实用医学杂志, 2023 , 39(16) : 2112 -2115 . DOI: 10.3969/j.issn.1006-5725.2023.16.017
Objective To investigate the efficacy and safety of chemotherapy plus immunotherapy and recombinant human endostatin in treating patients with advanced non-small cell lung cancer （NSCLC）. Methods We retrospectively reviewed and analyzed the medical records of 24 patients with advanced NSCLC treated with chemotherapy plus immunotherapy and recombinant human endostatin in Guangzhou Chest Hospital from June 2020 to December 2022. We focused on analyses of progression-free survival （PFS） and objective response rate （ORR） as well as disease control rate （DCR） and adverse events （AEs）. Results At 19.2 months′ median follow-up， the median PFS （mPFS） was 11 months （95%CI：8.722 ~ 13.278）. Among them， 11 patients received first-line treatment with an mPFS of 11 months （95%CI：9.782 ~ 12.218）. The 6-month and 12-month PFS rates were 82.4% and 52.9%， respectively. The first-line treatment elicited an ORR of 58.8%， and a DCR of 94.1%. Among the 17 cases， 2 came out with grade 3 - 4 AEs， taking up 11.8%， among which hematotoxicity was the most common， and 8 with grade 1 - 2 AEs， taking up 47.1%， among which hematotoxicity accounted for 17.6%， pruritus for 17.6% and hepatic toxicity for 5.9%. Conclusion Chemotherapy plus immunotherapy and endostatin promises good efficacy and safety in treating patients with advanced NSCLC.
| 1 | RECK M， REMON J， HELLMANN M D. First-Line Immunotherapy for Non-Small-Cell Lung Cancer［J］. J Clin Oncol， 2022，40（6）：586-597. |
| 2 | PETITPREZ F， MEYLAN M， DE REYNIèS A， et al. The Tumor Microenvironment in the Response to Immune Checkpoint Blockade Therapies［J］. Front Immunol， 2020，11：784. |
| 3 | JAIN R K. Normalization of tumor vasculature： an emerging concept in antiangiogenic therapy［J］. Science， 2005，307（5706）：58-62. |
| 4 | HU H， CHEN Y， TAN S， et al. The Research Progress of Antiangiogenic Therapy， Immune Therapy and Tumor Microenvironment［J］. Front Immunol， 2022，13：802846. |
| 5 | REN S， XIONG X， YOU H， et al. The Combination of Immune Checkpoint Blockade and Angiogenesis Inhibitors in the Treatment of Advanced Non-Small Cell Lung Cancer［J］. Front Immunol， 2021，12：689132. |
| 6 | LING Y， YANG Y， LU N， et al. Endostar， a novel recombinant human endostatin， exerts antiangiogenic effect via blocking VEGF-induced tyrosine phosphorylation of KDR/Flk-1 of endothelial cells［J］. Biochem Biophys Res Commun， 2007，361（1）：79-84. |
| 7 | HU W， FANG J， NIE J， et al. Efficacy and safety of extended use of platinum-based doublet chemotherapy plus endostatin in patients with advanced nonsmall cell lung cancer［J］. Medicine （Baltimore）， 2016，95（28）：e4183. |
| 8 | MéNDEZ-VALDéS G， GóMEZ-HEVIA F， LILLO-MOYA J， et al. Endostatin and Cancer Therapy： A Novel Potential Alternative to Anti-VEGF Monoclonal Antibodies［J］. Biomedicines， 2023，11（3）：718. |
| 9 | ZHOU C， WANG Z， SUN Y， et al. Sugemalimab versus placebo， in combination with platinum-based chemotherapy， as first-line treatment of metastatic non-small-cell lung cancer （GEMSTONE-302）： interim and final analyses of a double-blind， randomised， phase 3 clinical trial［J］. Lancet Oncol， 2022，23（2）：220-233. |
| 10 | WANG Z， WU L， LI B， et al. Toripalimab Plus Chemotherapy for Patients With Treatment-Naive Advanced Non-Small-Cell Lung Cancer： A Multicenter Randomized Phase III Trial （CHOICE-01） ［J］. J Clin Oncol， 2023，41（3）：651-663. |
| 11 | SONG Y， FU Y， XIE Q，et al. Anti-angiogenic Agents in Combination With Immune Checkpoint Inhibitors： A Promising Strategy for Cancer Treatment［J］. Front Immunol， 2020，11：1956. |
| 12 | RECK M， MOK TSK， NISHIO M， et al. Atezolizumab plus bevacizumab and chemotherapy in non-small-cell lung cancer （IMpower150）： key subgroup analyses of patients with EGFR mutations or baseline liver metastases in a randomised， open-label phase 3 trial［J］. Lancet Respir Med， 2019，7（5）：387-401. |
| 13 | CHU T， ZHONG R， ZHONG H， et al. Phase 1b Study of Sintilimab Plus Anlotinib as First-line Therapy in Patients With Advanced NSCLC［J］. J Thorac Oncol， 2021，16（4）：643-652. |
| 14 | 武阳，陆翰杰，水会锋.既往免疫经治的晚期非小细胞肺癌患者接受安罗替尼联合PD-1单抗的疗效及安全性［J］. 实用医学杂志， 2023，39（5）：572-578. |
| 15 | LV W， PEI X， ZHAO W， et al. Safety and efficacy of nivolumab plus recombinant human endostatin in previously treated advanced non-small-cell lung cancer［J］. Transl Lung Cancer Res， 2022，11（2）：201-212. |
| 16 | WANG B， XU L， LI Q， et al. Endostar continuous versus intermittent intravenous infusion combined with chemotherapy for advanced NSCLC： a systematic review and meta-analysis including non-randomized studies［J］. BMC Cancer， 2020，20（1）：1021. |
/
| 〈 |
|
〉 |