帕博利珠单抗加小剂量阿帕替尼联合治疗老年食管癌的有效性及安全性

doi:10.3969/j.issn.1006-5725.2024.24.016

Abstract

Abstract:

Objective To evaluate the efficacy and safety of pabolizumab plus low-dose apatinib combined chemotherapy in elderly patients with esophageal cancer. Methods A total of 188 elderly patients with esophageal cancer admitted to Shengli Oilfield Central Hospital from May 2020 to July 2022 were selected and divided into study group （n = 94） and control group （n = 94） by random number table method. The control group received pabolizumab combined with FP chemotherapy regimen， and the study group received low-dose Apatinib combined with Pabolizumab and FP chemotherapy regimen. Clinical efficacy， tumor markers， phosphatidylinositol 3 kinase （PI3K）/threonine protein kinase （Akt） signaling protein pathway， immune function， adverse reactions and survival were compared between the two groups. Results The objective remission rate of the study group was higher than control group （P < 0.05）. After treatment， squamous cell carcinoma antigen （SCC）， carcinoembryonic antigen （CEA）， PI3K， Akt and CD8⁺ were all decreased in the two groups （P < 0.05）， and those in study group were lower （P < 0.05）. After treatment， CD3⁺ and CD4⁺ were increased in both groups （P < 0.05）， and higher in study group （P < 0.05）. There was no difference in the total incidence of adverse reactions between the two groups （P > 0.05）. The survival rate of the study group was higher than control group （P < 0.05）. Conclusion Pabolizumab plus low-dose apatinib combined with chemotherapy is effective in the treatment of elderly esophageal cancer， which may inhibit tumor progression by reducing the activity of PI3K/Akt signaling protein pathway and improve the short-term survival rate.

Key words: pabolizumab, apatinib, chemotherapy, esophageal cancer, old age, security, effectiveness

CLC Number:

R735.1

Tingting ZHANG,Ke LIU,Dan CHEN,Bingwen YAN,Peijuan ZHAO,Ning. WANG. Efficacy and safety analysis of pabolizumab plus low⁃dose apatinib combined chemotherapy in elderly patients with esophageal cancer[J]. The Journal of Practical Medicine, 2024, 40(24): 3534-3538.

Figures/Tables 6

Tab.1

Comparison of clinical data"

组别	例数	性别/例		年龄/岁	卡氏功能状态评分/分	临床分期/例		淋巴结转移/例		肿瘤位置/例
组别	例数	男	女	年龄/岁	卡氏功能状态评分/分	Ⅲ期	Ⅳ期	是	否	下段食管	中段食管	上段食管
对照组	94	54	40	74.56 ± 6.31	72.15 ± 5.06	52	42	76	18	48	10	36
研究组	94	58	36	74.98 ± 6.39	72.84 ± 5.17	60	34	72	22	52	16	26
t/ $χ 2$ 值		0.353		0.453	0.925	1.414		0.508		3.158
P值		0.552		0.651	0.356	0.234		0.476		0.206

Tab.1

Tab.2

Tab.3

Tab. 4

Tab. 5

Fig.1

References 26

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组别	例数	CR	PR	SD	PD	客观缓解率
对照组	94	2（2.13）	34（36.17）	28（29.79）	30（31.91）	36（38.30）
研究组	94	4（4.26）	52（55.32）	22（23.40）	16（17.02）	56（59.57）

组别	例数	SCC/（mg/L）		CEA/（μg/L）		PI3K/（μg/L）		Akt/（μg/L）
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	94	3.21 ± 0.38	2.73 ± 0.26^?	15.43 ± 4.20	10.12 ± 3.27^?	34.16 ± 4.25	13.10 ± 2.97^?	30.07 ± 4.84	9.29 ± 1.93^?
研究组	94	3.30 ± 0.36	2.25 ± 0.21^?	16.38 ± 4.54	9.03 ± 2.48^?	35.27 ± 4.89	7.29 ± 1.65^?	31.32 ± 4.28	6.12 ± 1.31^?
t值		1.667	13.924	1.489	2.575	1.661	16.580	1.876	13.176
P值		0.097	< 0.001	0.138	0.011	0.098	< 0.001	0.062	< 0.001

组别	例数	CD3⁺		CD4⁺		CD8⁺
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	94	52.43 ± 4.06	57.24 ± 5.67^?	24.16 ± 3.29	28.34 ± 4.25^?	40.09 ± 4.16	36.28 ± 3.53^?
研究组	94	53.20 ± 4.98	68.41 ± 6.88^?	24.85 ± 3.68	32.19 ± 5.17^?	41.23 ± 4.72	32.11 ± 2.64^?
t值		1.162	12.147	1.355	5.577	1.757	9.172
P值		0.247	< 0.001	0.177	< 0.001	0.081	< 0.001

组别	例数	骨髓抑制			乏力
组别	例数	Ⅰ~Ⅱ级	Ⅲ~Ⅳ级	总发生率	Ⅰ~Ⅱ级	Ⅲ~Ⅳ级	总发生率
对照组	94	12（12.77）	0（0.00）	12（12.77）	10（10.64）	2（2.13）	12（12.77）
研究组	94	14（14.89）	2（2.13）	16（17.02）	14（14.89）	4（4.26）	18（19.15）
χ²值				0.671			1.428
P值				0.413			0.232

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Efficacy and safety analysis of pabolizumab plus low⁃dose apatinib combined chemotherapy in elderly patients with esophageal cancer

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