贝伐珠单抗联合奥希替尼治疗伴EGFRT790M突变的晚期NSCLC的疗效观察

Curative Effect of Bevacizumab Combined with Osimertinib in Advanced NSCLC with EGFRT790M Mutation

目的探讨伴表皮生长因子受体-T790M(EGFRT790M)突变的晚期非小细胞肺癌(NSCLC)应用贝伐珠单抗联合奥希替尼治疗的临床疗效。方法选取接受治疗并经病理检查证实伴EGFRT790M突变的晚期NSCLC患者102例进行研究。应用随机数字表法将上述患者分为对照组(n=51)与观察组(n=51)。对照组患者给予奥希替尼治疗,观察组患者给予贝伐珠单抗联合奥希替尼治疗,两组患者均治疗3个月。比较两组患者的近期疗效、远期疗效、血清指标[糖类抗原125(CA125)、癌胚抗原(CEA)、血管内皮生长因子(VEGF)]以及治疗过程中的不良反应。结果观察组患者治疗有效率为56.86%,高于对照组患者的治疗有效率(35.29%)(P<0.05);观察组患者有效控制率为88.24%,与对照组患者的有效控制率(78.43%)比较无统计学差异(P>0.05);观察组患者进展率为23.53%,低于对照组患者的进展率(47.06%)(P<0.05);观察组患者无进展生存期长于对照组患者(P<0.05);观察组患者病死率为9.80%,低于对照组患者病死率(31.37%)(P<0.05);治疗3个月后,观察组患者CA125、CEA、VEGF水平均低于对照组患者(P<0.05);治疗过程中,观察组不良反应率与对照组比较无统计学意义(P>0.05)。结论贝伐珠单抗联合奥希替尼治疗伴EGFRT790M突变的晚期NSCLC患者的临床疗效良好,可提高患者无进展生存期、降低肿瘤标志物表达水平。

Objective To explore the clinical curative effect of bevacizumab combined with osimertinib in advanced non-small cell lung cancer(NSCLC)with epidermal growth factor receptor-T790M(EGFRT790M)mutation.Methods A total of 102 patients with advanced NSCLC and EGFRT790M mutation who were treated and pathologically confirmed were enrolled.According to random number table method,they were divided into the control group(n=51)and the observation group(n=51).The control group was treated with osimertinib,while the observation group was treated with bevacizumab combined with osimertinib for 3 months.The short-term and long-term curative effect,serum indexes[carbohydrate antigen 125(CA125),carcinoembryonic antigen(CEA),vascular endothelial growth factor(VEGF)]and adverse reactions during treatment were compared between the 2 groups.Results The response rate of treatment in the observation group was higher than that in the control group(56.86%vs 35.29%,P<0.05).There was no significant difference in effective control rate between the 2 groups(88.24%vs 78.43%,P>0.05).The progression rate in the observation group was lower than that of the control group(23.53%vs 47.06%,P<0.05),progression-free survival was longer than that of the control group(P<0.05),and mortality was lower than that of the control group(9.80%vs 31.37%,P<0.05).After 3 months of treatment,levels of CA125,CEA and VEGF in the observation group were lower than those of the control group(P<0.05).During treatment,there was no significant difference in incidence of adverse reactions between the 2 groups(P>0.05).Conclusion The clinical curative effect of bevacizumab combined with osimertinib is good in patients with advanced NSCLC and EGFRT790M mutation,which can prolong progression-free survival and reduce expression levels of tumor markers.