贝伐珠单抗一线治疗驱动基因阴性晚期肺腺癌的效果与安全性

Efficacy and Safety of Bevacizumab in the First-Line Treatment of Advanced Driver-Gene Negative Lung Adenocarcinoma

目的 观察贝伐珠单抗在一线治疗驱动基因阴性的晚期转移性肺腺癌中的效果及安全性。方法 回顾性分析2020年12月至2022年6月在郑州大学第一附属医院确诊并接受治疗的60例驱动基因阴性的晚期转移性肺腺癌患者的临床资料,按治疗方式分为观察组(28例)和对照组(32例)。观察组接受贝伐珠单抗、卡瑞利珠单抗、培美曲塞和顺铂治疗,对照组接受卡瑞利珠单抗、培美曲塞和顺铂治疗。比较两组治疗效果及不良事件发生情况,同时比较亚组间治疗效果。结果 观察组患者的中位无进展生存期(mPFS)长于对照组(P=0.031),短期疗效评估中客观缓解率(ORR)优于对照组(P=0.045)。观察组出现3例3级不良事件,但两组3~4级不良事件的发生率比较,差异无统计学意义(P>0.05)。在肝转移人群中,观察组mPFS长于对照组(P=0.019);在高肿瘤突变负荷(TMB)人群中,观察组mPFS长于对照组(P=0.034)。结论 在驱动基因阴性的晚期转移性肺腺癌的一线治疗中,贝伐珠单抗的应用有较好的临床效果,患者整体安全性良好。

Objective To observe the efficacy and safety of bevacizumab in the first-line treatment of advanced driver-gene negative lung adenocarcinoma.Methods The clinical data of 60 patients with advanced metastatic lung adenocarcinoma with negative driving gene diagnosed and treated in the First Affiliated Hospital of Zhengzhou University from December 2020 to June 2022 were retrospectively analyzed. According to the different treatment method, the patients were divided into observation group(28 cases) and control group(32 cases). The observation group was treated with bevacizumab, camrelizumab, pemetrexed, cisplatin, and the control group was treated with camrelizumab, pemetrexed and cisplatin. The therapeutic effects and adverse events were compared between the two groups, and the therapeutic effects between subgroups were also compared.Results The median progression-free survival(mPFS) of the observation group was longer than that of the control group(P=0.031), and the objective response rate(ORR) of the observation group was better than that of the control group(P=0.045). There were 3 cases of grade 3 adverse events in the observation group, but there was no difference in the incidence of grade 3 and grade 4 adverse events between the two groups(P>0.05). In the patients with liver metastasis, the mPFS of the observation group was longer than that of the control group(P=0.019). In the population with high tumor mutation burden(TMB), the mPFS of the observation group was longer than that of the control group(P=0.034).Conclusion In the first-line treatment of advanced driver-gene negative lung adenocarcinoma, the application of bevacizumab have better clinical effect, and the overall safety of the patients is good.