PD-1抑制剂联合安罗替尼一线治疗老年晚期驱动基因阴性非鳞非小细胞肺癌患者的疗效及安全性分析

Efficacy and safety of PD-1 inhibitor combined with anlotinib in first-line treatment of elderly patients with advanced driver gene-negative non-squamous non-small cell lung cancer

目的研究程序性死亡蛋白-1(PD-1)抑制剂联合安罗替尼一线治疗老年晚期驱动基因阴性非鳞非小细胞肺癌(NSCLC)患者的疗效及安全性。方法采用回顾性分析,选取2020年1月至12月广东医科大学附属湛江中心人民医院收治的60例老年晚期驱动基因阴性非鳞NSCLC患者为研究对象,根据治疗方法不同分为研究组(n=30)与对照组(n=30)。研究组行PD-1抑制剂联合安罗替尼一线治疗,对照组行PD-1抑制剂一线治疗。比较两组患者的无进展生存期(PFS)、总生存期(OS)、客观缓解率(ORR)、疾病控制率(DCR)及不良事件(恶心呕吐、咯血、高脂血症、高血压、蛋白尿、手足综合征、乏力、食欲下降、贫血、血小板减少、中性粒细胞减少)发生情况。结果研究组患者的中位PFS和OS为5.4、10.6个月,均明显长于对照组(4.2、8.9个月),差异有统计学意义(P<0.05)。研究组ORR、DCR为33.33%、70.00%,均明显高于对照组(10.00%、43.33%),差异有统计学意义(P<0.05)。两组患者不良事件发生率比较,差异均无统计学意义(P>0.05)。结论PD-1抑制剂联合安罗替尼一线治疗老年晚期驱动基因阴性非鳞NSCLC疗效显著,安全性好。

Objective To investigate the efficacy and safety of programmed death-1(PD-1)inhibitor combined with anlotinib in the first-line treatment of elderly patients with advanced driver gene-negative non-squamous non-small cell lung cancer(NSCLC).Methods By retrospective analysis,60 elderly patients with advanced driver gene-negative non-squamous NSCLC admitted to Zhanjiang Central People’s Hospital from January to December 2020 were enrolled.According to different treatment methods,they were divided into study group(n=30)and control group(n=30).The study group received first-line treatment with PD-1 inhibitor combined with anlotinib,while the control group received first-line treatment with PD-1 inhibitor.The progression-free surial(PFS)and overall survival(OS),the objective response rate(ORR),disease control rates(DCR),adverse events(nausea and vomiting,haemoptysis,hyperlipemia,hypertension,proteinuria,extremities syndrome,fatigue,loss of appetite,anemia,thrombocytopenia,and neutropenia)happening were compared between two groups.Results The median PFS and OS of the study group were 5.4,10.6 months,which were significantly longer than those of the control group(4.2,8.9 months),and the differences were statistically significant(P<0.05).The ORR and DCR were 33.33%,70.00%,which were significantly higher than those of the control group(10.00%,43.33%),and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse events between the two groups(P>0.05).Conclusion PD-1 inhibitor combined with anlotinib is effective and safe in the first-line treatment of advanced driver negative non-squamous NSCLC in elderly patients.