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紫杉醇和卡铂联合或不联合贝伐珠单抗治疗伴有间质性肺病的晚期非鳞状非小细胞肺癌患者的安全性和有效性。

The safety and efficacy of paclitaxel and carboplatin with or without bevacizumab for treating patients with advanced nonsquamous non-small cell lung cancer with interstitial lung disease.

机构信息

Department of Respiratory Medicine, Kobe City Medical Center General Hospital, 2 Minatojima-minamimachi, Chuo-ku, Kobe, 650-0047, Japan,

出版信息

Cancer Chemother Pharmacol. 2014 Dec;74(6):1159-66. doi: 10.1007/s00280-014-2590-x. Epub 2014 Sep 23.

Abstract

PURPOSE

Optimal chemotherapy for patients with advanced non-small cell lung cancer (NSCLC) with interstitial lung disease (ILD) is established for paclitaxel and carboplatin, but is otherwise controversial. Therefore, we assessed the efficacy and safety of paclitaxel and carboplatin with or without bevacizumab for treating these patients.

METHODS

We analyzed the outcomes of 21 patients with advanced nonsquamous NSCLC with ILD who received paclitaxel and carboplatin without (paclitaxel-carboplatin group; n = 11) or with bevacizumab (paclitaxel-carboplatin-bevacizumab group; n = 10) between April 2008 and October 2013.

RESULTS

The median progression-free survival time of the paclitaxel-carboplatin-bevacizumab group was 5.3 months (95 % CI 0.4-11.6 months) compared with 4.4 months (95 % CI 0.9-6.3 months) for the paclitaxel-carboplatin group (p = 0.060). Their respective median overall survival times were 16.1 months (range 0.4-34.8 months) and 9.7 months (range 2.6-37.0 months) (p = 0.772) with corresponding overall response rates of 40 and 27 % (p = 0.659), respectively. One patient in the paclitaxel-carboplatin-bevacizumab group experienced chemotherapy-related exacerbation of ILD (0/11 vs. 1/10; p = 0.476).

CONCLUSIONS

The addition of bevacizumab to paclitaxel and carboplatin may provide an effective and safe treatment option for patients with advanced nonsquamous NSCLC with ILD.

摘要

目的

对于患有间质性肺病(ILD)的晚期非小细胞肺癌(NSCLC)患者,已确定紫杉醇和卡铂为最佳化疗药物,但其他药物仍存在争议。因此,我们评估了紫杉醇和卡铂联合或不联合贝伐单抗治疗这些患者的疗效和安全性。

方法

我们分析了 2008 年 4 月至 2013 年 10 月期间接受紫杉醇和卡铂治疗(紫杉醇-卡铂组,n=11)或紫杉醇、卡铂和贝伐单抗治疗(紫杉醇-卡铂-贝伐单抗组,n=10)的 21 例晚期非鳞状 NSCLC 合并 ILD 患者的结局。

结果

与紫杉醇-卡铂组的 4.4 个月(95%CI:0.9-6.3 个月)相比,紫杉醇-卡铂-贝伐单抗组的中位无进展生存期为 5.3 个月(95%CI:0.4-11.6 个月)(p=0.060)。两组的中位总生存期分别为 16.1 个月(范围:0.4-34.8 个月)和 9.7 个月(范围:2.6-37.0 个月)(p=0.772),总缓解率分别为 40%和 27%(p=0.659)。紫杉醇-卡铂-贝伐单抗组中有 1 例患者出现与化疗相关的 ILD 恶化(0/11 比 1/10;p=0.476)。

结论

在紫杉醇和卡铂的基础上加用贝伐单抗可能为合并 ILD 的晚期非鳞状 NSCLC 患者提供一种有效且安全的治疗选择。

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