曲拉西利联合免疫联合化疗一线治疗晚期非小细胞肺癌1例及文献分析

Trilaciclib in combination with immunotherapy plus chemotherapy as the first-line treatment for non-small cell lung cancer:a case-report and literature-review

国家癌症中心发布的最新统计数据显示,肺癌仍是我国发病率和死亡率最高的恶性肿瘤。同时,肺癌的发病率及死亡率逐年攀升,对癌症患者及社会造成了严重的负担。非小细胞肺癌(non-small cell lung cancer,NSCLC)是肺癌的主要病理类型,约占全部肺癌的85%左右。晚期NSCLC患者的5年生存率较低,目前,化疗仍然是晚期肺癌治疗的基石。细胞毒类药物会损伤骨髓内的造血干细胞,导致骨髓抑制,使患者因不能耐受而中止治疗。针对骨髓抑制的传统治疗手段可能会引发其他不良反应,如骨髓造血储备功能耗竭等。2022年7月,曲拉西利获批用于预防小细胞肺癌化疗引起的骨髓抑制。曲拉西利能有效预防化疗引起的骨髓抑制,并且不会拮抗化疗的抗肿瘤作用。本文特报道1例曲拉西利联合免疫联合化疗一线治疗晚期NSCLC的病例,以期为临床实践提供进一步的参考。

According to the latest statistical data from the National Cancer Registry,lung cancer still ranks the first in morbidity and mortality among all kinds of malignancies in China.Both the morbidity and mortality of lung cancer are increasing year by year,causing a heavy burden to both society and families.Non-small cell lung cancer(NSCLC)remains the main pathological type of lung cancer,accounting for approximately 85%.To date,the 5-year survival rate of the patients with advanced NSCLC remains very low.Chemotherapy is still considered the cornerstone for the treatment of advanced NSCLC.Cytotoxic drugs can damage hematopoietic stem cells in the bone marrow,resulting in bone marrow suppression,and the patients have to stop the treatment due to intolerance.Traditional therapies for myelosuppression may cause other side effects,including depletion of bone marrow hematopoietic reserve.In July 2022,trilaciclib was approved by National Medical Products Administration(NMPA)for preventing bone marrow suppression in small-cell lung cancer.Previous studies showed that trilaciclib could effectively prevent bone marrow suppression without influencing anti-tumor efficacy.This case report aims to report a case of trilaciclib combined with immunotherapy plus chemotherapy for the prevention of myelosuppression in the first-line treatment of patients with advanced NSCLC,aiming to provide reference and basis for clinical practice.