免疫疗法联合靶向治疗对转移性结直肠癌的疗效及安全性研究

Efficacy and Safety of Immunotherapy Combined with Targeted Therapy for Metastatic Colorectal Cancer

目的:评估卡瑞利珠单抗联合抗血管生成药物治疗转移性MSS结直肠癌的疗效与安全性。方法:收集2021年6月到2022年6月期间在唐山市人民医院放化科接受卡瑞利珠单抗联合抗血管生成药物(呋喹替尼/瑞戈非尼)或单药抗血管生成药物(呋喹替尼/瑞戈非尼)三线治疗的转移性MSS结直肠患者40例(联合组、单药组各20例)。评价两组的总生存期(OS)、疾病控制率(DCR)和客观缓解率(ORR),同时统计两组的不良事件发生率。结果:与单药组相比,联合组患者临床一般资料差异无统计学意义。联合组和单药组的中位OS分别为11个月和7.5个月,DCR分别为85%和60%,ORR分别为30%和10%。联合组和单药组的不良事件发生率分别在95%和90%,不良事件多为1~2级,严重不良事件(≥3级)的发生率分别为15%和10%,无4级不良反应。联合组毛细血管发生率高于单药组。结论:联合组可改善患者的OS获益,但是与单药组差异无统计学意义。免疫疗法联合抗血管生成类药物治疗是一种有前景的策略,两者联合可改善患者的生存获益,在晚期转移性结直肠癌的治疗中显现出更好的抗肿瘤活性,且安全性较高,为发展针对CRC的免疫靶向治疗提供了重要的依据。

Objective:To evaluate the efficacy and safety of carrellizumab combined with anti-angiogenic agents in the treatment of metastatic MSS colorectal cancer.Methods:A total of 40 colorectal patients with metastatic MSS were enrolled in the radiotherapy Department of Tangshan People's Hospital from June 2021 to June 2022,who received third-line treatment with carrilizumab combined with anti-angiogenic agents(fuquitinib/regorafenib)or single-agent anti-angiogenic agents(fuquitinib/regorafenib)(20 in the combination group and 20 in the monotherapy group).Overall survival(OS),disease control rate(DCR)and objective response rate(ORR)of the two groups were evaluated,and the incidence of adverse events in the two groups were statistically analyzed.Results:Compared with the monotherapy group,there was no significant difference in the general clinical data of the combined group.The median OS in the combination and monotherapy groups was 11 and 7.5 months,DCR was 85%and 60%,and ORR was 30%and 10%,respectively.The incidence of adverse events in the combination group and the monotherapy group was 95%and 90%,respectively.Most of the adverse events were grade 1-2,and the incidence of serious adverse events(≥grade 3)was 15%and 10%,respectively,without grade 4 adverse events.The incidence of capillaries in combination group was higher than that in monotherapy group.Conclusion:The combination group has improved benefit for patients with OS,but the difference is not statistically significant compared with the monotherapy group.Immunotherapy combined with anti-angiogenic drugs is a promising strategy,and the combination of the two can improve the survival benefits of patients,showing better anti-tumor activity and high safety in the treatment of advanced metastatic colorectal cancer,providing an important basis for the development of immunotargeted therapy for CRC.