免疫检查点抑制剂在奥希替尼耐药非小细胞肺癌治疗中的应用

Immune checkpoint inhibitor in the treatment of osimertinib-resistant non-small cell lung cancer

目的探讨基于免疫检查点抑制剂的联合治疗对奥希替尼耐药非小细胞肺癌(NSCLC)患者的疗效。方法纳入125例存在表皮生长因子受体突变且对奥希替尼耐药的晚期NSCLC患者,其中接受免疫检查点抑制剂联合化疗和(或)抗血管生成治疗的50例患者为观察组,其余接受化疗或化疗联合抗血管生成治疗的75例患者为对照组。结果观察组客观有效率和疾病控制率分别为20.00%、62.00%,对照组分别为10.67、54.67%,差异均无统计学意义(χ^(2)=2.120,P=0.145;χ^(2)=0.661,P=0.416)。观察组中位疾病无进展生存期为4.07个月,优于对照组的3.03个月(χ^(2)=4.186,P=0.041)。基于免疫检查点抑制剂的联合治疗可降低预后风险(HR=0.665,95%CI:0.448~0.987,P=0.043)。结论基于免疫检查点抑制剂的联合治疗改善了奥希替尼耐药NSCLC患者的生存,并降低了患者的预后风险。

Objective To investigate the efficacy of combination therapy based on immune checkpoint inhibitors in the treatment of osimertinib-resistant non-small cell lung cancer(NSCLC).Methods The 125 patients with advanced non-small cell lung cancer with epidermal growth factor receptor mutations who had acquired resistance to osimertinib were included.Fifty patients in the observation group received a combination regimen of immune checkpoint inhibitors combined with chemotherapy and(or)anti-angiogenic therapy,75 patients in the control group received chemotherapy or chemotherapy combined with anti-angiogenic therapy.Results The objective effective rate and disease control rate were 20.00%and 62.00%in the observation group,and were 10.67%and 54.67%in the control group(χ^(2)=2.120,P=0.145;χ^(2)=0.661,P=0.416).The median progression-free survival in the observation group(4.07 months)was longer than that in the control group(3.03 months;χ^(2)=4.186,P=0.041).Combination therapy based on immune checkpoint inhibitor re-duced the prognostic risk(HR=0.665,95%CI:0.448-0.987,P=0.043).Conclusion Combination therapy based on immune checkpoint inhibitors improved the survival of osimertinib-resistant NSCLC patients,and reduced the prognostic risk.