Department of Thoracic Oncology, Tianjin Lung Cancer Center, Tianjin Cancer Institute and Hospital, Tianjin Medical University, Tianjin 300060, People's Republic of China.
J Cancer Res Clin Oncol. 2012 Jun;138(6):927-37. doi: 10.1007/s00432-012-1167-5. Epub 2012 Feb 14.
The present study was designed to elucidate the fluctuation of activated CECs (aCECs) during different therapies and to investigate their predictive value for efficacy of anti-angiogenesis and chemotherapy in advanced non-small cell lung cancer (NSCLC).
Seventy-two patients were randomized into three arms, treated with concomitant NP (vinorelbine and cisplatin) and Rh-endostatin, Rh-endostatin followed by NP, and single NP up to a maximum of six cycles. Response, time to progression (TTP), and aCECs levels were observed. The correlation between aCECs and efficacy was analyzed.
We found that TTP was 8.5 months in concomitant NP and Rh-endostatin versus 5.3 months in NP (p = 0.04) and 6.0 months in Rh-endostatin followed by NP. aCECs fluctuated during the therapeutic period, with a significantly high level from baseline on 8th day of Rh-endostatin followed by NP regimen, that is, when single Rh-endostatin was administered for 1 week, and upon completion of therapy in cases of progressive disease in each group (all p < 0.05). When TTP was longer than 10 months, aCECs count difference (∆aCECs, the difference in the aCECs by post-therapeutic amount minus pre-therapeutic amount) was reversely correlated to TTP (p = 0.003, r = -0.647).
An improved synergistic effect was achieved from concomitant NP and Rh-endostatin compared with Rh-endostatin followed by NP and single NP. aCECs increased when the disease was aggravated or single Rh-endostatin treatment of Rh-endostatin was administered, while they decreased when a clinical response to the combined therapy was obtained. Our results suggest ∆aCECs as an ideal marker to predict the response to Rh-endostatin combined with chemotherapy.
本研究旨在阐明活化的循环内皮细胞（aCECs）在不同治疗期间的波动情况，并探讨其对晚期非小细胞肺癌（NSCLC）抗血管生成和化疗疗效的预测价值。
72 名患者被随机分为三组，分别接受 NP（长春瑞滨和顺铂）联合雷莫芦单抗、雷莫芦单抗序贯 NP 以及 NP 单药治疗，最多 6 个周期。观察患者的疗效、无进展生存期（TTP）和 aCECs 水平。分析 aCECs 与疗效的相关性。
我们发现，NP 联合雷莫芦单抗组的 TTP 为 8.5 个月，明显长于 NP 组的 5.3 个月（p = 0.04）和雷莫芦单抗序贯 NP 组的 6.0 个月。在治疗期间，aCECs 发生波动，雷莫芦单抗序贯 NP 组在第 8 天（即单独给予雷莫芦单抗治疗 1 周时）和各组疾病进展时（均 p < 0.05）的 aCECs 水平显著高于基线。当 TTP 长于 10 个月时，aCECs 计数差值（∆aCECs，治疗后 aCECs 数量减去治疗前 aCECs 数量的差值）与 TTP 呈负相关（p = 0.003，r = -0.647）。
NP 联合雷莫芦单抗组与雷莫芦单抗序贯 NP 组和 NP 单药组相比，疗效有明显改善。当疾病加重或单独给予雷莫芦单抗治疗时，aCECs 增加，而当联合治疗获得临床疗效时，aCECs 减少。我们的结果表明，∆aCECs 是预测雷莫芦单抗联合化疗疗效的理想标志物。
