帕博利珠单抗联合新辅助化疗治疗非小细胞肺癌的近期疗效和安全性

Short-term efficacy and safety of pembrolizumab combined with neoadjuvant chemotherapy for the treatment of non-small cell lung cancer

目的探讨帕博利珠单抗联合新辅助化疗治疗可切除非小细胞肺癌的近期疗效及安全性。方法回顾性分析2019年12月—2021年6月于西安交通大学第一附属医院胸外科行帕博利珠单抗联合新辅助化疗的11例男性非小细胞肺癌患者的临床资料,年龄52.0~79.0(62.0±6.9)岁。对比新辅助治疗前后的影像学资料及病理学改变,记录新辅助治疗过程中的不良反应,以客观缓解率、主要病理缓解率及病理完全缓解率为主要观察终点。结果经帕博利珠单抗联合铂类或紫杉醇进行新辅助治疗后,全组患者均成功进行了胸腔镜肺癌根治术。客观缓解率为72.7%,主要病理缓解率为81.8%,其中,45.5%的患者达到了病理完全缓解。主要的不良反应为低白蛋白血症、食欲下降及恶心。术后30 d内死亡率为0,未观察到肿瘤转移。结论帕博利珠单抗联合新辅助化疗治疗可切除非小细胞肺癌安全可行,可有效改善患者预后。

Objective To explore the short-term efficacy and safety of pembrolizumab combined with chemotherapy in the neoadjuvant treatment of non-small cell lung cancer.Methods The clinical data of 11 male patients with non-small cell lung cancer who underwent pembrolizumab combined with neoadjuvant chemotherapy in the Department of Thoracic Surgery,the First Affiliated Hospital of Xi’an Jiaotong University from December 2019 to June2021 were retrospectively analyzed.The average age of the patients was 52.0-79.0(62.0±6.9)years.The imaging data and pathological changes before and after neoadjuvant treatment were compared,and adverse reactions during neoadjuvant treatment were recorded.Objective remission rate(ORR)and main pathological remission rate(MPR)and pathological complete remission rate(pCR)were the main observation endpoints.Results After preoperative neoadjuvant therapy with pembrolizumab combined with platinum or paclitaxel,all patients successfully underwent thoracoscopic radical resection of lung cancer.The ORR was 72.7%,and the MPR was 81.8%.Among them,45.5%of patients achieved pCR.The main adverse reactions were hypoalbuminemia,decreased appetite and nausea.The mortality rate within 30 days after surgery was 0,and no tumor metastasis was observed.Conclusion Pembrolizumab combined with neoadjuvant chemotherapy is safe and feasible to treat non-small cell lung cancer,and the short-term efficacy is beneficial.