安罗替尼治疗晚期非小细胞肺癌疗效预测因素的回顾性研究

Study of the predictive factors associated with anlotinib in advanced non-small cell lung cancer patients:a retrospective study

目的探索安罗替尼治疗晚期非小细胞肺癌(NSCLC)的潜在疗效标志物的预测价值,以更好地指导临床用药。方法回顾性分析2018年5月至2020年10月在上海交通大学医学院附属瑞金医院接受安罗替尼治疗的部分晚期NSCLC患者的临床特征、肿瘤组织血管生成信号通路相关基因单核苷酸多态性(SNP)等因素,探索潜在预测因子及其预测价值。结果共纳入96例患者,其中40例进行了SNP检测。乳酸脱氢酶水平≤200 IU/L患者中位无进展生存(PFS)期更长;C反应蛋白≤9.2 mg/L、中性粒细胞数值≤7×10^(9)/L患者具有更长的中位总生存(OS)期;安罗替尼治疗后出现肺空洞化患者中位OS期较短。与其他基因型相比,肺癌组织携带rs699947-VEGF AC基因型者有更长的中位PFS。结论基线血清乳酸脱氢酶、C反应蛋白、中性粒细胞水平和患者预后相关;安罗替尼治疗后出现肺空洞化与更差的中位OS期相关。rs699947-VEGF AC基因型是安罗替尼治疗晚期NSCLC较好疗效的预测因子。

Objective To investigate the predictive value of the factors associated with anlotinib efficacy in treatment of advanced non-small cell lung cancer(NSCLC),so as to better guide clinical medication.Methods The advanced NSCLC patients who received anlotinib therapy from 1 May 2018 to 31 October 2020 at Ruijin Hospital were enrolled in this study.The patient clinical features and single-nucleotide polymorphisms(SNPs)involved in angiogenesis pathway genes in tumor tissues were collected,and explored their potential predictors and predictive value associated with anlotinib efficacy.Results A total of 96 patients with advanced NSCLC were enrolled,in which 40 patientsreceived SNPs detection in tumor tissues.The patients with LDH≤200 IU/L had longer median progress-free survival(mPFS),and the median overall survival(mOS)was much longer in patients with a lower level of C reactive protein(CRP≤9.2 mg/L)or neutrophils(NEU≤7×10^(9)/L)than the patients with a high level of CRP or NEU.Moreover,the patients with lung cavitation development after anlotinib therapy had shorter mOS.We also found that the patients with rs699947-VEGF AC genotype had longer mPFS than those with other genotypes.Conclusions The lower levels of LDH,CRP,NEU in serum predicted better prognosis,and the occurrence of lung cavity after anlotinib therapy associated with shorter mOS.The presence of rs699947-VEGF AC genotype may be a monitor in anlotinib therapy and predict clinical efficacy of anlotinib in advanced NSCLC patients.