摘要
目的探讨真实世界中程序性死亡受体-1(programmed death receptor-1,PD-1)/程序性死亡受体-配体1(programmed death receptor-ligand 1,PD-L1)抑制剂治疗ⅢB~Ⅳ期非小细胞肺癌(non-small cell lung cancer,NSCLC)的临床疗效和安全性,并分析潜在的预后相关因素。方法回顾性分析2018年9月~2020年7月在徐州医科大学附属医院接受PD-1/PD-L1抑制剂治疗的ⅢB~Ⅳ期NSCLC患者的临床资料,探讨该治疗的临床疗效、不良反应及预后相关因素。结果共纳入112例NSCLC患者,其中疗效达到部分缓解(immune partial response,iPR)15例,疾病稳定(immune stable disease,iSD)28例,确定疾病进展(immune confirmed progressive disease,iCPD)69例,总体客观缓解率(objective response rate,ORR)为13.4%,疾病控制率(disease control rate,DCR)为38.4%。至随访截止时间,全组患者中位无进展生存期(median progression-free survival,mPFS)为5个月,中位总生存期(median overall survival,mOS)为17个月。COX多因素回归分析结果显示,美国东部肿瘤协作组(Eastern Cooperative Oncology Group,ECOG)体力状况(physical status,PS)评分、体重指数(body mass index,BMI)、TNM分期、肝转移及脑转移为患者PFS的独立影响因素。PS评分、治疗线数及LDH水平是影响患者OS的独立预后因素。结论真实世界中应用PD-1/PD-L1抑制剂能为晚期NSCLC患者带来生存获益,且安全性良好。一线早期使用免疫治疗、PS评分0~1分及低LDH水平的患者预后可能更好。
Objective This study aimed to investigate the clinical efficacy and safety of programmed death receptor-1(PD-1)/programmed death receptor-ligand 1(PD-L1)inhibitors in non-small cell lung cancer(NSCLC)in the real world and analyze the potential prognostic factors.Methods We retrospectively analyzed the clinical data of 112 patients with stageⅢB~ⅣNSCLC treated with PD-1/PD-L1 inhibitors at the Affiliated Hospital of Xuzhou Medical University from September 2018 to July 2020,with follow-up until September 1,2021.Recent efficacy was evaluated after at least 3 cycles of treatment.Medication was continued until progression or severe toxic effects occurred,and long-term outcomes were assessed.Survival analysis was performed using Kaplan-Meier and COX regression analysis.Results Among 112 enrolled patents 15 patients achieved partial remission(iPR),28 patients had stable disease(iSD),and 69 patients had definite disease progression(iCPD),with an overall objective remission rate(ORR)of 13.4%and a disease control rate(DCR)of 38.4%.The median progression-free survival(mPFS)was 5 months and the median overall survival(mOS)was 17 months for the whole group of patients by the follow-up cut-off time.COX multifactorial regression analysis showed that Eastern Cooperative Oncology Group(ECOG)physical status(PS)score,body mass index(BMI),TNM stage,liver metastasis and brain metastasis were independent influencing factors for patients′PFS.The PS score,number of treatment lines and LDH level were independent prognostic factors for OS in patients with shadowing.Conclusion In the real world,PD-1/PD-L1 inhibitors may bring survival benefits to patients with stageⅢB toⅣNSCLC.Patients with first-line early immunotherapy,PS score 0 to 1 and low LDH level may have a better prognosis.
作者
朱庆
马庆功
孙建
顾玉明
ZHU Qing;MA Qinggong;SUN Jian(Affiliated Hospital of Xuzhou Medical University,Jiangsu 221006,China)
出处
《医学研究杂志》
2023年第6期169-174,193,共7页
Journal of Medical Research
