纳武利尤单抗注射液治疗晚期非小细胞肺癌致免疫相关性肺炎的分析

Correlation analysis of nivolumab injection in the treatment of immune-related pneumonia caused by non-small cell lung cancer

目的分析纳武利尤单抗注射液治疗非小细胞肺癌(NSCLC)的临床疗效,及其致免疫相关性肺炎的相关性。方法 160例晚期NSCLC患者均给予3mg·kg^(-1)纳武利尤单抗,静脉滴注,每2周用药1次,持续治疗至患者不耐受或疾病进展。统计治疗期间所有患者的临床疗效,比较免疫相关性肺炎发生者与未发生者的临床特征。结果治疗后,所有患者的总有效率为38.75%(62例/160例)。免疫相关性肺炎的发生率为11.25%,其中55.56%为Ⅰ~Ⅱ级肺炎,44.44%为Ⅲ~Ⅳ级肺炎。免疫相关性肺炎发生者> 60岁、合并吸烟史患者占比均显著高于未发生者(均P <0.05)。结论纳武利尤单抗治疗晚期NSCLC的临床疗效确切,但其致免疫相关性肺炎的风险高,与患者的年龄、吸烟史相关,临床治疗期间需密切监测。

Objective To analyze the clinical efficacy of nivolumab injection in the treatment of non-small cell lung cancer(NSCLC) and its correlation with immune-associated pneumonia.Methods A total of 160 patients with advanced NSCLC were treated with intravenous infusion of 3 mg·kg^(-1) nivolumab,once every 2 weeks,until patient intolerance or disease progression.The clinical efficacy of all patients during the treatment period was counted,and the clinical characteristics of patients with and without immune-associated pneumonia were compared.Results After treatment,the total effective rate of all patients was 38.75%(62 cases/160 cases).The incidence of immune-related pneumonia was 11.25 %,of which 55.56% was grade Ⅰ—Ⅱpneumonia and 44.44% were grade Ⅲ—Ⅳ pneumonia.The proportion of patients with immune-associated pneumonia> 60 years old and complicated with smoking history was higher than that of patients without immune-associated pneumonia(all P <0.05).Conclusion Nivolumab injection has a definitive clinical efficacy in the treatment of advanced NSCLC,but it has a high risk of immune-associated pneumonia related to the patient’s age and smoking history,which should be closely monitored during clinical treatment.