卡瑞利珠单抗联合培美曲塞和奈达铂治疗EGFR/ALK野生型晚期非鳞状NSCLC的临床观察

Clinical observation of camrelizumab combined with pemetrexed and nedaplatin in the treatment of EGFR/ALK wild-type advanced non-squamous non-small cell lung cancer

目的观察卡瑞利珠单抗联合培美曲塞和奈达铂治疗表皮生长因子受体(EGFR)和间变性淋巴瘤激酶(ALK)野生型晚期非鳞状非小细胞肺癌(NSCLC)的疗效和安全性。方法回顾性收集2021年8月至2023年5月于重庆医科大学附属第一医院就诊的92例EGFR/ALK野生型晚期非鳞状NSCLC患者资料,根据治疗方案的不同分为奈达铂组(46例)和卡铂组(46例)。奈达铂组患者给予注射用卡瑞利珠单抗+注射用奈达铂+注射用培美曲塞二钠;卡铂组患者给予注射用卡瑞利珠单抗+卡铂注射液+注射用培美曲塞二钠。两组均以21 d为1个周期,所有患者至少完成2个周期的治疗。观察两组患者的近期疗效和不良反应发生情况,分析影响患者无进展生存期(PFS)的因素。结果两组患者的客观缓解率、疾病控制率、中位PFS、3~5级治疗相关不良事件(TRAE)发生率比较,差异均无统计学意义(P>0.05)。奈达铂组患者的1~2级肾脏和泌尿系统TRAE、心慌、心包积液发生率均显著低于卡铂,恶心、呕吐和食欲降低发生率显著高于卡铂组(P<0.05)。患者的性别、年龄、有无吸烟史、美国东部肿瘤协作组织评分和TNM分期均不是影响患者PFS的因素(P>0.05)。结论卡瑞利珠单抗联合培美曲塞和奈达铂治疗EGFR/ALK野生型晚期非鳞状NSCLC的疗效显著,安全性较好。

OBJECTIVE To observe the efficacy and safety of camrelizumab combined with pemetrexed and nedaplatin in the treatment of epidermal growth factor receptor(EGFR)and anaplastic lymphoma kinase(ALK)wild-type advanced non-squamous non-small cell lung cancer(NSCLC).METHODS The data of 92 patients with EGFR/ALK wild-type advanced non-squamous NSCLC patients who visited the First Affiliated Hospital of Chongqing Medical University from August 2021 to May 2023 were collected and divided into nedaplatin group(46 cases)and carboplatin group(46 cases)based on different treatment regimens.Nedaplatin group was given camrelizumab for injection+nedaplatin for injection+pemetrexed disodium for injection;carboplatin group was given camrelizumab for injection+carboplatin injection+pemetrexed disodium for injection.Both groups received treatment with 21 days as one cycle,and all patients would be treated at least two cycles.The recent efficacy and the incidence of adverse drug reactions were observed in two groups,and the factors affecting progression-free survival(PFS)of patients were analyzed.RESULTS There was no statistically significant difference in the objective response rate,disease control rate,median PFS,and the incidence of grade 3-5 treatment-related adverse event(TRAE)between the two groups(P>0.05).While the incidence of grade 1-2 renal and urinary system TREA,palpitations and pericardial effusion in nedaplatin group were significantly lower than carboplatin group,the incidence of nausea,vomiting and decreased appetite were significantly higher than carboplatin group(P<0.05).The patient’s gender,age,smoking history,Eastern United States Cancer Collaboration score,and TNM staging were not significant factors affecting patient’s PFS(P>0.05).CONCLUSIONS Camrelizumab combined with pemetrexed and nedaplatin has significant efficacy in the treatment of EGFR/ALK wild-type advanced non-squamous NSCLC,with good safety.