PD-1抑制剂与化学疗法联合应用治疗HER2阴性晚期胃癌临床观察

Efficacy of PD-1 inhibitor combined with chemotherapy in the treatment of HER2-negative patients with advanced gastric cancer

目的观察程序性细胞死亡分子-1(PD-1)抑制剂与化学疗法(化疗)联合应用治疗人类表皮生长因子受体2(HER2)阴性晚期胃癌的疗效。方法107例一线治疗失败的HER2阴性晚期胃癌患者根据不同的治疗方案分为观察组(57例)和对照组(50例),观察组采用PD-1抑制剂联合化疗治疗,对照组单纯采用化疗治疗,比较两组近期疗效[客观缓解率(ORR)、疾病控制率(DCR)]、远期疗效[中位总生存期、中位无进展生存期(mPFS)]及不良反应。结果与对照组比较,观察组ORR、DCR高(P均<0.05);与对照组比较,观察组mPFS长(P<0.05)。与对照组比较,观察组发生3~4级不良反应事件胃肠道反应例数多(P<0.05)。结论PD-1抑制剂联合化疗治疗HER2阴性晚期胃癌患者效果良好,相对于单纯化疗,可显著提高患者的ORR和DCR,并显著延长患者的无进展生存期,不良反应安全可控。

Objective To evaluate the efficacy of programmed cell death-1(PD-1)inhibitor combined with chemotherapy in the treatment of human epidemal growth factor receptor 2(HER2)-negative advanced gastric cancer.Methods According to different treatment regimens,107 patients with HER2-negative advanced gastric cancer were divided into the observation group(n=57)and control group(n=50).The patients in the observation group were treated with PD-1 inhibitor combined with chemotherapy.The patients in the control group were treated with chemotherapy alone.The shortterm efficacy[objective response rate(ORR),disease control rate(DCR)],long-term effect[median overall survival time,median progression-free survival time(mPFS)],and adverse reactions were compared between the two groups.Results Compared with the control group,the ORR and DCR of the observation group were higher,and the mPFS of the observation group was longer than that of the control group(all P<0.05).Compared with the control group,the number of gastrointestinal reactions of grade 3-4 adverse events in the observation group was larger than that in the control group(P<0.05).Conclusions PD-1 inhibitor combined with chemotherapy is effective in the treatment of HER2-negative patients with advanced gastric cancer.Compared with chemotherapy alone,it can significantly improve the ORR and DCR of the patients,and prolong the PFS of the patients.The adverse reactions are safe and controllable.