奥希替尼联合尼妥珠单抗一线治疗表皮生长因子受体突变晚期非小细胞肺癌患者的临床疗效

Clinical efficacy of osimertinib combined with nimotuzumab in first-line treatment of advanced non-small cell lung cancer patients with epidermal growth factor receptor mutation

目的探讨奥希替尼联合尼妥珠单抗一线治疗表皮生长因子受体(EGFR)突变晚期非小细胞肺癌(NSCLC)患者的临床疗效。方法依据治疗方式的不同将160例EGFR突变晚期NSCLC患者分为观察组和对照组,每组80例,对照组患者给予奥希替尼治疗,观察组患者给予奥希替尼联合尼妥珠单抗治疗。比较两组患者的临床疗效、血清肿瘤标志物[癌胚抗原(CEA)、细胞角质蛋白19片段抗原21-1(CYFRA21-1)、糖类抗原125(CA125)]水平、血清生长因子[胰岛素样生长因子-1(IGF-1)、血管内皮生长因子(VEGF)]水平、不良反应发生情况及随访1年生存情况。结果治疗3个月后,观察组患者的治疗总有效率为57.50%,高于对照组患者的38.75%,差异有统计学意义(P﹤0.05)。治疗后,两组患者血清CEA、CYFRA21-1、CA125、VEGF、IGF-1水平均低于本组治疗前,观察组患者CEA、CYFRA21-1、CA125、VEGF、IGF-1水平均低于对照组,差异均有统计学意义(P﹤0.05)。两组患者腹泻、恶心呕吐、皮疹、肝功能损伤及肾功能损伤发生率比较,差异均无统计学意义(P﹥0.05)。观察组患者的1年生存率为96.25%,高于对照组患者的78.75%,差异有统计学意义(P﹤0.05)。结论奥希替尼联合尼妥珠单抗一线治疗EGFR突变晚期NSCLC疗效显著,能够降低患者肿瘤标志物和生长因子水平,改善患者的预后,安全性良好。

Objective To investigate the clinical efficacy of osimertinib combined with nimotuzumab in first-line treatment of advanced non-small cell lung cancer(NSCLC)patients with epidermal growth factor receptor(EGFR)mutation.Method According to different treatment methods,160 patients with EGFR mutant advanced NSCLC were divided into observation group and control group,with 80 cases in each group.Patients in the control group were treated with osimertinib,while patients in the observation group were treated with osimertinib combined with nimotuzumab.The clinical efficacy,serum tumor markers[carcinoembryonic antigen(CEA),cyto-keratin 19 fragment antigen 21-1(CYFRA21-1),carbohydrate antigen 125(CA125)]levels,serum growth factors[insulin-like growth factor-1(IGF-1),vascular endothelial growth factor(VEGF)]levels,incidence of adverse reactions,and survival status of 1-year follow up were compared between the two groups.Result After 3 months of treatment,the total effective rate of the observation group was 57.50%,which was higher than 38.75%of the control group,and the difference was statistically significant(P<0.05).After treatment,the serum levels of CEA,CYFRA21-1,CA125,VEGF,and IGF-1 in both groups were lower than those before treatment,the levels of CEA,CYFRA21-1,CA125,VEGF,and IGF-1 in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).There were no statistically significant differences in the incidence of diarrhea,nausea and vomiting,rash,liver function damage,and kidney function damage between the two groups(P>0.05).The 1-year survival rate of patients in the observation group was 96.25%,which was higher than 78.75%in the control group,and the difference was statistically significant(P<0.05).Conclusion Osimertinib combined with nimotuzumab in first-line treatment of EGFR mutant advanced NSCLC shows significant effi-cacy,which can reduce tumor marker and growth factor levels and improve prognosis,with good safety.