特瑞普利单抗联合阿昔替尼在晚期肾癌中的初步应用

Preliminary effects of toripalimab combined with axitinib in the treatment of advanced renal cell carcinoma

目的分析特瑞普利单抗联合阿昔替尼治疗晚期肾细胞癌的初步疗效与安全性。方法回顾性收集北京大学肿瘤医院接受特瑞普利单抗联合阿昔替尼治疗的50例晚期肾癌患者的临床资料,分析客观缓解率(ORR)、疾病控制率(DCR)、无疾病进展时间(PFS)和总生存时间(OS)。结果50例患者中男性37例;中位年龄为56(22~73)岁;病理确诊为肾透明细胞癌38例、非透明细胞癌12例,常见转移部位包括肺、骨、淋巴结、肝等,其中90%患者既往接受过至少一线抗肿瘤药物的系统性治疗。中位随访时间11.9(0.8~24)个月,50例患者中仍有27例在继续治疗,总体ORR 34%、DCR 86%、PFS 13.1个月(95%CI 5.8~20.4),中位OS尚未达到,1年OS率为84.6%。常见不良反应主要为蛋白尿、腹泻、高血压、甲状腺功能异常、转氨酶升高、手足综合征等,主要以1~2级为主。结论特瑞普利单抗联合阿昔替尼在晚期肾癌治疗中可见初步疗效,不良反应可控。

Objective To analyze the efficacy and safety of toripalimab combined with axitinib in the treatment of advanced renal cell carcinoma.Methods Clinical data of 50 patients with advanced renal cell carcinoma who received axitinib combined with toripalimab were retrospectively collected from the database of Peking University Cancer Hospital.ORR,DCR,PFS,and OS were analyzed.Results Among the 50 patients,37 were males;median age was 56(22-73)years;38 were pathologically diagnosed as clear cell renal cell carcinoma and 12 were non-clear cell carcinoma.Common metastatic sites included lung,bone,lymph node,liver,and so on.90%of the patients had received at least one-line of systemic therapy.With a median follow-up time of 11.9 months(0.8-24),27 of the 50 patients are still on treatment,ORR was 34%,DCR was 86%,median PFS was 13.1 months(95%CI 5.8-20.4),and median OS has not yet reached.One-year OS rate was 84.6%.Common adverse reactions were proteinuria,diarrhea,hypertension,abnormal thyroid function,elevated transaminase,and hand-foot syndrome.Most adverse events were grade 1-2.Conclusion Toripalimab combined with axitinib was efficient in the treatment of advanced renal cell carcinoma,and had manageable adverse reactions.