程序性死亡受体1抑制剂治疗晚期恶性肿瘤的临床观察

Clinical Observation of Programmed Death Receptor-1 Inhibitors in the Treatment of Advanced Cancer

目的观察程序性死亡受体1(PD-1)抑制剂治疗晚期恶性肿瘤的临床疗效及不良反应。方法回顾性分析PD-1抑制剂治疗30例晚期恶性肿瘤患者的临床疗效及不良反应。结果 30例患者在接受PD-1抑制剂治疗2周期(Pembrolizumab)或3周期(Nivolumab)后,完全缓解0例,部分缓解10例,病情稳定8例,疾病进展12例,有效率33.3%,疾病控制率60.0%。截止至随访结束,18例出现疾病无进展生存时间终点事件,14例出现总生存时间终点事件,中位疾病无进展生存时间为102 d。淋巴瘤亚组有效率66.7%,疾病控制率88.9%,中位疾病无进展生存时间为320 d。肺癌亚组有效率28.6%,疾病控制率57.1%,中位疾病无进展生存时间为84 d。全组不良反应发生率53.3%,其中Ⅰ、Ⅱ度占90.9%,Ⅲ、Ⅳ度占9.1%。结论 PD-1抑制剂治疗中国人晚期恶性肿瘤有一定疗效,但在不同类型的肿瘤疗效存在差异,淋巴瘤患者疗效最优。总体药物不良反应发生率较高,但都在可控范围。

Objective To observe the clinical effect and toxicities of programmed death receptor-1(PD-1)inhibitors with advanced cancer.Methods Thirty patients with advanced cancer were retrospectively analyzed.The effect and toxicities of PD-1inhibitors(Nivolumab or Pembrolizumab)was evaluated.Results After two cycles(Pembrolizumab)or three cycles(Nivolumab)of treatment,among the30patients,no patients experienced complete response,10patients experienced partial response,8patients were with stable diseases,12patients were with progression disease,the objective response rate was33.3%,and the disease control rate was60.0%.The median progress free survival time was102days.Subgroup analysis of lymphoma:The objective response rate was66.7%and the disease control rate was88.9%,the median progress free survival time was320days.Subgroup analysis of lung cancer:The objective response rate was28.6%and the disease control rate was57.1%,the median progress free survival time was84days.Among the30patients,the incidence of toxicities was53.3%.Conclusion PD-1inhibitors is effective for advanced cancer in China,but the effective rate is different in kinds of cancers and the best effective cancer is lymphoma.The overall toxicities of PD-1inhibitors are high,but all are in a controllable range.