瑞戈非尼联合PD-1制剂治疗复发转移性结直肠癌的临床疗效观察

Clinical observation on the efficacy of Regorafenib combined with PD-1 agent in the treatment of recurrent and metastatic colorectal cancer

目的探讨瑞戈非尼联合程序性细胞死亡受体1(PD-1)制剂治疗复发转移性结直肠癌的临床效果。方法选取2022年1月至6月新余市人民医院肿瘤科收治的50例复发转移性结直肠癌的患者(既往接受≥2线系统性治疗的晚期结直肠癌患者)作为研究对象,按照随机数字表法分为观察组(25例)与对照组(25例),对照组采用口服瑞戈非尼治疗,观察组采用口服瑞戈非尼联合卡瑞利珠单抗治疗。比较两组的疗效、癌胚抗原(CEA)、糖类抗原72-4(CA72-4)、糖类抗原19-9(CA19-9)水平、内皮生长因子[血管内皮生长因子(VEGF)、基质金属蛋白酶9(MMP-9)、表皮生长因子受体(EGFR)、人表皮生长因子受体2(HER-2)]水平、不良反应发生情况。结果两组患者有效率(RR)、疾病控制率(DCR)比较,差异无统计学意义(P>0.05)。干预前,两组CEA、CA72-4、CA19-9水平比较,差异无统计学意义(P>0.05);干预后,两组患者的CEA、CA72-4、CA19-9水平低于本组干预前,且观察组患者的CEA、CA72-4、CA19-9水平低于对照组,差异有统计学意义(P<0.05)。干预前,两组患者的VEGF、MMP-9、EGFR、HER-2水平比较,差异无统计学意义(P>0.05);干预后,两组患者的VEGF、MMP-9、EGFR、HER-2水平低于本组干预前,且观察组患者的VEGF、MMP-9、EGFR、HER-2水平低于对照组,差异有统计学意义(P<0.05)。观察组患者的不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论瑞戈非尼联合PD-1制剂治疗复发转移性结直肠癌效果佳,能够改善患者的CEA、CA72-4、CA19-9水平、内皮生长因子水平,同时不增加患者不良反应的发生。

Objective To investigate the clinical effect of Regorafenib combined with programmed cell death receptor 1(PD-1)in the treatment of recurrent and metastatic colorectal cancer.Methods A total of 50 patients with recurrent and metastatic colorectal cancer(patients with advanced colorectal cancer who had received≥2 lines of systemic therapy)admitted to the Department of Oncology,Xinyu People's Hospital from January to June 2022 were selected as the research objects.According to the random number table method,they were divided into observation group(25 cases)and control group(25 cases).The control group was treated with Regorafenib,and the observation group was treated with Regorafenib combined with Camrelizumab.The efficacy,carcinoembryonic antigen(CEA),carbohydrate antigen 72-4(CA72-4),carbohydrate antigen 19-9(CA19-9),endothelial growth factors(vascular endothelial growth factor[VEGF],matrix metalloproteinase 9[MMP-9],epidermal growth factor receptor[EGFR],human epidermal growth factor receptor-2[HER-2]),and adverse reactions were compared between the two groups.Results There was no significant difference in response rate(RR)and disease control rate(DCR)between the two groups(P>0.05).Before intervention,there were no statistically significant differences in the levels of CEA,CA72-4 and CA19-9 between the two groups(P>0.05).After intervention,the levels of CEA,CA72-4 and CA19-9 of the two groups were lower than those before intervention,and the levels of CEA,CA72-4 and CA19-9 of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).Before intervention,there were no statistically significant differences in the levels of VEGF,MMP-9,EGFR and HER-2 between the two groups(P>0.05).After the intervention,the levels of VEGF,MMP-9,EGFR and HER-2 in the two groups were lower than those before the intervention,and the levels of VEGF,MMP-9,EGFR and HER-2 in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the observation group was lower than that in the control group, and the difference was statistically significant (P<0.05). Conclusion Regorafenib combined with PD-1 preparation is effective in the treatment of recurrent and metastatic colorectal cancer, which can improve the levels of CEA, CA72-4, CA19-9 and endothelial growth factor, and does not increase the incidence of adverse reactions.