程序性死亡受体-1抑制剂联合安罗替尼二线疗法治疗晚期食管鳞癌的临床疗效及安全性

Clinical efficacy and safety of programmed death 1 inhibitors combined with anlotinib as the second-line therapy in treating patients with advanced esophageal squamous cell carcinoma

目的 分析程序性死亡受体-1(PD-1)抑制剂联合安罗替尼二线治疗晚期食管鳞癌的临床疗效及安全性。方法 选取2021年1月-2022年6月组织病理学确诊的68例晚期食管鳞癌患者,在一线含铂方案化疗失败后,采用PD-1抑制剂联合安罗替尼靶向治疗,其中32例患者联合卡瑞利珠单抗,20例患者联合信迪利单抗,16例患者联合特瑞普利单抗免疫治疗。分析3组临床疗效及安全性。结果 68例患者经疗效评估18例部分缓解,40例疾病稳定,10例疾病进展。客观缓解率、疾病控制率分别为26.5%、85.3%,中位无进展生存期为7.5个月(95%CI为6.6~8.4),中位总生存期未达到。安全性方面,不良反应多为1~2级,3级不良反应发生率为14.7%,未发生4~5级不良反应;所有不良反应经对症治疗后均能缓解。结论 晚期食管鳞癌患者二线治疗采用PD-1抑制剂联合安罗替尼可显著获益,且不良反应可控。

Objective To analyze the clinical efficacy and safety of programmed death 1(PD-1)inhibitors combined with anlotinib as the second-line therapy in treating patients with advanced esophageal squamous cell carcinoma.Methods A total of 68 patients with advanced esophageal squamous cell carcinoma diagnosed by histopathology from January 2021 to June 2022 were selected,and they were treated with PD-1 inhibitors plus arotinib targeted therapy after failure of first-line platinum containing chemotherapy regimen,including 32 cases with camrelizumab,20 cases with sintilimab,and 16 cases with treprinumab immunotherapy.The clinical efficacy and safety of three groups were analyzed.Results After efficacy evaluation for 68 patients,there were 18 cases of partial remission,40 cases of stable disease,and 10 cases of disease progression.The objective response rate and disease control rate were 26.5%and 85.3%respectively,the median progression free survival was 7.5 months(95%CI,6.6 to 8.4),and the median overall survival was not achieved.In terms of safety,the most adverse reactions were at grade 1 and 2,the incidence of adverse reactions at grade 3 was 14.7%,and adverse reactions at grade 4 and 5 were not observed;all the adverse reactions alleviated after performing targeted treatment.Conclusion Patients with advanced esophageal squamous cell carcinoma can significantly benefit from the combination of PD-1 inhibitors and anlotinib as the second-line therapy,and the adverse reactions are controllable.