阿帕替尼联合卡瑞利珠单抗治疗经治晚期小细胞肺癌的临床观察

Efficacy and Safety of Apatinib Plus Camrelizumab in Patients With Previously Treated Advanced Small Cell Lung Cancer

目的探讨阿帕替尼联合卡瑞利珠单抗在经治晚期小细胞肺癌患者中的安全性和有效性。方法回顾性收集42例经治晚期小细胞肺癌患者的临床资料,治疗方案为阿帕替尼250 mg po Qd,卡瑞利珠单抗200 mg静脉滴注,3周1次,直至疾病进展或出现无法忍受的毒性。观察近期疗效、中位无进展生存期、中位生存期及不良反应。结果42例患者评估疗效和安全性,CR 2例(4.76%),PR 15例(35.71%),SD 16例(38.10%),PD 9例(21.43%),ORR为40.48%,DCR为78.57%。中位PFS为6.24个月,中位OS为10.23个月。不良反应多为1~2级。非血液学毒性主要不良反应为高血压(45.23%)、蛋白尿(23.81%)、手足综合征(28.57%)、皮疹(19.05%)。全组患者未发生严重不良反应导致治疗中断或停止,未出现过敏反应。结论阿帕替尼联合卡瑞利珠单抗用于治疗经治晚期小细胞肺癌有较好的协同抗肿瘤作用,有显著临床疗效,安全性高,不良反应少。

Objective The aim of this study was to assess the safety and efficacy of apatinib plus camrelizumab for advanced small cell lung cancer patients who have received previously treatments.Methods A total of 42 patients with previously treated advanced small cell lung cancer in our hospital from November 2019 to March 2022 were analyzed,All Patients received apatinib orally at 250 mg per a day and camrelizumab intravenously at 200 mg every three weeks until disease progression or intolerable toxicity occurred.Efficacy was evaluated based on the Response Evaluation Criteria in Solid Tumors RECIST Version 1.1(RECIST 1.1).Adverse events(AEs)were assessed by the National Cancer Institute Common Terminology Criteria for Adverse Events(CTCAE version 5.0).The primary endpoint was objective response rate(ORR).Secondary endpoints included disease control rate(DCR),progression-free survival(PFS),overall survival(OS),and safety.Results Among 42 patients we could conduct efficacy evaluations,2 patients(4.76%)achieved a complete response(CR),15 patients(35.71%)achieved partial response(PR),16 patients(38.10%)had stable disease(SO),and 9 patients(21.43%)achieved progressive disease(PD),the objective response rate(ORR)was 40.48%,disease control rate(DCR)was 78.57%.The median overall survival was 10.23 months,and the median progression-free survival was 6.24 months.Adverse events were mainly of grade 1 to 2.The main adverse events(AEs)of nonhematdogical toxicitywere hypertension(45.23%),proteinuria(23.81%),hand-foot syndrome(28.57%)and rash(19.05%).No drug withdrawal or fatal events occured.Conclusion Camrelizumab combined with apatinib demonstrated feasible anti-tumor activity and manageable safety in patients with previously treated advanced small cell lung cancer.