特瑞普利单抗联合PP方案治疗非鳞状非小细胞肺癌的疗效研究

Study on the Therapeutic Effect of Toripalimab Combined with PP Regimen in the Treatment of Non Squamous Non-small Cell Lung Cancer

目的观察特瑞普利单抗联合PP方案(培美曲塞^(+)顺铂)治疗非鳞状非小细胞肺癌(NSCLC)的疗效。方法采用历史对照研究方法,将50例采用PP方案治疗的非鳞状NSCLC患者纳入对照组,将50例采用特瑞普利单抗联合PP方案治疗的非鳞状NSCLC患者纳入观察组,治疗2个周期评估疗效。比较治疗前、治疗2个周期时外周血程序性死亡受体1(PD-1)mRNA、程序性死亡受体配体1(PD-L1)mRNA水平,免疫功能指标[T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))]及肿瘤标志物[癌胚抗原(CEA)、细胞角蛋白19片段抗原21-1(CYFRA21-1)、糖类抗原125(CA125)],治疗期间不良反应发生情况。结果治疗2个周期时,与对照组比较,观察组治疗总有效率高(P<0.05);两组PD-1 mRNA、PD-L1 mRNA水平均降低,且与对照组比较,观察组低(P<0.05);两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均较治疗前降低,但与对照组比较,观察组上述指标水平均高(P<0.05);两组CEA、CYFRA21-1水平均较治疗前降低,且与对照组比较,观察组上述指标水平均低(P<0.05)。治疗期间两组各项不良反应发生率比较,差异不显著(P>0.05)。结论特瑞普利单抗联合PP方案治疗非鳞状NSCLC疗效确切,可调节PD-1表达水平,减轻化疗药物引起的免疫抑制程度,降低肿瘤标志物水平,且不增加不良反应。

Objective To observe the therapeutic effect of the combination of toripalimab and PP regimen(pemetrexed^(+)cisplatin)in the treatment of non-small cell lung cancer(NSCLC).Methods A historical controlled study method was used to include 50 non-scale NSCLC patients treated with PP regimen in the control group,and 50 non-scale NSCLC patients treated with toripalimab combined with PP regimen in the observation group.The efficacy was evaluated for 2 treatment cycles.The levels of programmed cell death protein 1(PD-1)mRNA and programmed death receptor ligand 1(PD-L1)mRNA in peripheral blood before and during the 2 treatment cycles,immune function indicators[T lymphocyte subpopulations(CD3^(+),CD4^(+),CD4^(+)/CD8^(+))],tumor markers[carcinoembryonic antigen(CEA),cytokeratin 19 fragment antigen 21-1(CYFRA21-1),and carbohydrate antigen 125(CA125)]were compared before treatment and at 2 cycles of treatment,and the incidence of adverse reactions during treatment was compared.Results Compared with the control group,the observation group had a higher total effective rate of treatment during 2 cycles of treatment(P<0.05).The levels of PD-1 mRNA and PD-L1 mRNA in both groups decreased,and compared with the control group,the observation group showed a lower level(P<0.05).The levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in both groups decreased compared to before treatment,but compared with the control group,the levels of the above indicators in the observation group were all higher(P<0.05).The levels of CEA and CYFRA21-1 in both groups decreased compared to before treatment,and compared with the control group,the observation group had lower levels of the above indicators(P<0.05).There was no significant difference in the incidence of adverse reactions between the 2 groups during treatment(P>0.05).Conclusion The combination of toripalimab and PP regimen is effective in the treatment of non-squamous NSCLC,which can regulate the expression level of PD-1,alleviate the degree of immune suppression caused by chemotherapy drugs,reduce the level of tumor markers,and do not increase adverse reactions.