安罗替尼联合程序性死亡受体1抑制剂治疗晚期肾细胞癌的临床疗效分析

Clinical efficacy of anlotinib combined with programmed death-1 inhibitor on advanced renal cell carcinoma

目的评价安罗替尼联合程序性死亡受体1(PD-1)抑制剂治疗晚期肾细胞癌的疗效和不良反应。方法入组2018年1月至2021年12月郑州大学第一附属医院收治的10例临床诊断为晚期肾细胞癌患者,治疗方案为口服安罗替尼12 mg,每天1次,连续服药2周,停药1周,同时给予卡瑞利珠单抗、替雷利珠单抗等PD-1抑制剂200 mg静脉滴注,每3周1次。结果10例晚期肾细胞癌患者中,部分缓解3例、疾病稳定6例、疾病进展1例,客观缓解率为30.0%(3/10),疾病控制率为90.0%(9/10),中位疾病无进展生存期为17.5个月。不良反应主要为食欲减退(4例)、恶心(3例)、蛋白尿(3例)、呕吐(2例)、高血压(2例)、手足皮肤反应(2例)、中性粒细胞减少(2例)、转氨酶升高(2例),大多为Ⅰ、Ⅱ度。结论安罗替尼联合PD-1抑制剂治疗晚期肾细胞癌疗效较好,且耐受性良好。

Objective To evaluate the efficacy and adverse reactions of anlotinib combined with programmed death-1(PD-1)inhibitor in the treatment of advanced renal cell carcinoma.Methods Ten patients with advanced renal cell carcinoma who were clinically diagnosed in the First Affiliated Hospital of Zhengzhou University from January 2018 to December 2021 were enrolled.The treatment regimen was anlotinib 12 mg qd,orally,for 2 weeks,and withdrawal for 1 week.At the same time,200 mg PD-1 inhibitor such as carrelizumab and tislelizumab were given intravenously,every 3 weeks.Results Among the 10 patients with advanced renal cell carcinoma,3 patients had partial response,6 patients had disease stability,and 1 patient had disease progression.The objective response rate was 30.0%(3/10),the disease control rate was 90.0%(9/10),and the median progression-free survival was 17.5 months.The adverse reactions of the 10 patients were mainly anorexia(4 patients),nausea(3 patients),proteinuria(3 patients),vomiting(2 patients),hypertension(2 patients),hand and foot skin reaction(2 patients),neutropenia(2 patients),and elevated aminotransferase(2 patients).Most of the adverse reactions were gradeⅠorⅡ.Conclusion Anlotinib combined with PD-1 inhibitor has a good efficacy on advanced renal cell carcinoma,and the adverse reactions are well tolerated.