安罗替尼联合纳武利尤单抗对晚期非小细胞肺癌患者免疫状态及短期预后的影响

Effects of arotinib combined with navulizumab on immune status and short-term prognosis in patients with advanced non-small cell lung cancer

目的分析安罗替尼联合纳武利尤单抗对晚期非小细胞肺癌患者免疫状态及短期预后的影响。方法本研究采用前瞻性分析。抽取河南黄河科技学院附属医院2020年8月至2022年8月收治的108例晚期非小细胞肺癌患者,采用随机数字表法分为对照组和观察组,每组54例。对照组给予安罗替尼治疗,观察组在对照组的治疗基础上给予纳武利尤单抗治疗,共治疗9周。治疗后两组均随访6个月。比较两组临床疗效[客观缓解率(ORR)、疾病控制率(DCR)]、随访6个月内预后情况及治疗期间不良反应发生率。比较两组治疗前后免疫状态(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、血管内皮生长因子(VEGF)水平。结果观察组ORR(38.89%,21/54)、DCR(92.59%,50/54)均高于对照组(20.37%,11/54;68.52%,37/54),差异有统计学意义(P<0.05)。治疗前,两组CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)比较差异未见统计学意义(P>0.05)。治疗9周后,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均上升,CD8^(+)均下降(P<0.05);且治疗9周后,观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于对照组,CD8^(+)低于对照组,差异有统计学意义(P<0.05)。治疗前,两组VEGF水平比较差异未见统计学意义(P>0.05);治疗9周后,两组VEGF水平均低于治疗前,且观察组低于对照组(P<0.05)。随访6个月内,观察组病死率(3.70%,2/54)低于对照组(14.81%,8/54),差异有统计学意义(χ2=3.97,P=0.046)。治疗期间,两组不良反应发生率比较差异未见统计学意义(P>0.05)。结论安罗替尼联合纳武利尤单抗可提高晚期非小细胞肺癌的治疗效果,改善患者免疫状态及短期预后情况,延长生存期,且具有一定安全性。

Objective To analyze the effect of arotinib combined with navulizumab on immune status and short-term prognosis in patients with advanced non-small cell lung cancer.Methods This study was a prospective trail.A total of 108 patients with advanced non-small cell lung cancer admitted to Huanghe Science and Technology College Affiliated Hospital from August 2020 to August 2022 were selected.They were divided into control group and observation group by random number table method,with 54 cases in each group.The control group was treated with arotinib,while the observation group was treated with navulizumab based on the treatment of the control group;both groups were treated for a total of 9 weeks.After treatment,patients of the two groups were followed up for 6 months.The clinical efficacy assessed by objective response rate(ORR)and disease control rate(DCR),prognosis during 6-month follow-up,and incidence of adverse reactions during treatment were compared between the two groups.The preoperative and postoperative immune status assessed by cluster of differentiation 3^(+)(CD3^(+)),cluster of differentiation 4^(+)(CD4^(+)),cluster of differentiation 8^(+)(CD8^(+))and CD4^(+)/CD8^(+),and levels of vascular endothelial growth factor(VEGF)were compared between the two groups.Results The ORR(38.89%,21/54)and DCR(92.59%,50/54)in the observation group were higher than those in the control group(20.37%,11/54;68.52%,37/54),with a significant difference(P<0.05).Before treatment,there was no significant difference between the two groups in CD3^(+),CD4^(+),CD8^(+),and CD4^(+)/CD8^(+)(P>0.05).After 9 weeks of treatment,the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in both groups increased,and the levels of CD8^(+)decreased(P<0.05),moreover,the observation group had higher levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+),but lower level of CD8^(+),compared with the control group(P<0.05).Before treatment,there was no statistically significant difference in VEGF level between the two groups(P>0.05).After 9 weeks of treatment,the VEGF level of both groups decreased,and the VEGF level of the observation group was lower than that of the control group(P<0.05).Within 6 months of follow-up,the case fatality rate in the observation group(3.70%,2/54)was significantly lower than that in the control group(14.81%,8/54),with a significant difference(χ2=3.97,P=0.046).During the treatment period,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions Arotinib combined with navulizumab can improve the therapeutic effects on advanced non-small cell lung cancer,improve the immune status and short-term prognosis of patients,and prolong the survival period,with certain safety.