阿昔替尼联合免疫药物治疗晚期肾癌的初步疗效观察

Preliminary analysis of the efficacy of axitinib combined with immunotherapy in the treatment of advanced renal cell carcinoma

目的初步观察阿昔替尼联合免疫药物在晚期肾癌患者治疗中的有效性和安全性。方法选取华中科技大学同济医学院附属同济医院2020年9月至2021年7月收治的8例晚期转移性肾癌患者为研究对象,使用阿昔替尼联合免疫药物治疗,方案为阿昔替尼5 mg,每日2次,连续口服,免疫药物使用替雷利珠单抗/信迪利单抗/帕博利珠单抗200 mg静脉滴注,每3周1次,3周为1个周期。联合用药至少2个周期后进行1次疗效评价,评价治疗效果与药物不良反应发生的情况。结果8例患者中位年龄为51.90(34.03~62.00)岁。所有患者均可评价疗效,其中未见完全缓解病例,部分缓解4例,疾病稳定2例,疾病进展2例,疾病控制率为75.00%(6/8),客观缓解率为50.00%(4/8)。患者所出现的药物不良反应主要为1~2级,且以甲状腺功能减退(5例)、腹泻(4例)、转氨酶升高(4例)等多见,对症处理后好转。结论阿昔替尼联合免疫药物治疗晚期肾癌的效果显著,多数不良反应可耐受。

Objective To observe the efficacy and safety of axitinib combined with immunotherapy in the treatment of advanced renal cell carcinoma.Methods From September 2020 to July 2021,8 patients with advanced renal cell carcinoma were enrolled.All patients received axitinib 5mg orally twice daily and tislelizumab/sintilimab/pembrolizumab 200 mg intravenously once every 3 weeks.After at least two cycles of combined therapy,the treatment efficacy and related adverse events were analyzed.Results The median age of 8 patients was 51.90 years(range 34.03-62.00).All cases could be evaluated.Four patients achieved partial response(PR),2 patients achieved stable disease(SD)and 2 patients achieved progressive disease(PD).Disease control rate(DCR)was 75.00%(6/8),and objective response rate(ORR)was 50.00%(4/8).The adverse events of the whole group were mainly grade 1 or 2,including hypothyroidism,diarrhea,increased aminotransferase and so on,which were ameliorated after symptomatic treatment.Conclusions Axitinib combined with immunotherapy in the treatment of advanced renal cell carcinoma shows significant efficacy,and the adverse events are generally controllable.