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起始纳武利尤单抗治疗时同时使用的药物对非小细胞肺癌结局的影响。

Impact of Concomitant Medication Administered at the Time of Initiation of Nivolumab Therapy on Outcome in Non-small Cell Lung Cancer.

机构信息

Department of Pneumology and Phthisiology, Charles University, Faculty of Medicine in Pilsen, Pilsen, Czech Republic

Department of Oncology, Charles University, First Faculty of Medicine in Prague, Prague, Czech Republic.

出版信息

Anticancer Res. 2020 Apr;40(4):2209-2217. doi: 10.21873/anticanres.14182.

Abstract

AIM

To investigate potential association between administration of corticosteroids, antibiotics, probiotics, proton pump inhibitors, non-steroidal anti-inflammatory drugs (NSAID), statins and metformin and outcome in patients with non-small cell lung cancer (NSCLC) treated with nivolumab.

PATIENTS AND METHODS

A total of 224 patients with advanced NSCLC treated at nine comprehensive cancer centers were analyzed in this national retrospective study. Survival statistics were evaluated using Kaplan-Meier method and Cox analysis.

RESULTS

Only corticosteroid use had a significant negative effect on the objective response rate. In the univariate analysis, there was no significant effect of the studied concomitant medications on the efficacy of nivolumab. In a subsequent multifactorial analysis, a possible positive effect of the concomitant use of NSAID at the initiation of nivolumab treatment was revealed.

CONCLUSION

The results of the present retrospective exploratory analysis underscore the importance of knowing the exact type of concomitant medication, the route of administration, the dose of medication, and the region of the ongoing study. The present data indicated a significantly higher rate of progression in patients treated with corticosteroids and the possible positive effect of NSAID use at the initiation of nivolumab treatment.

摘要

目的

研究在接受纳武利尤单抗治疗的非小细胞肺癌(NSCLC)患者中,皮质类固醇、抗生素、益生菌、质子泵抑制剂、非甾体抗炎药(NSAID)、他汀类药物和二甲双胍的给药与结局之间是否存在潜在关联。

患者与方法

本项全国性回顾性研究共分析了 9 家综合癌症中心的 224 例晚期 NSCLC 患者。采用 Kaplan-Meier 法和 Cox 分析评估生存统计数据。

结果

仅皮质类固醇的使用对客观缓解率有显著的负面影响。在单变量分析中,所研究的伴随药物对纳武利尤单抗的疗效没有显著影响。在随后的多因素分析中,发现纳武利尤单抗治疗起始时同时使用 NSAID 可能具有积极作用。

结论

本回顾性探索性分析的结果强调了了解确切类型的伴随药物、给药途径、药物剂量和正在进行研究的区域的重要性。本数据表明,接受皮质类固醇治疗的患者进展率显著更高,且纳武利尤单抗治疗起始时使用 NSAID 可能具有积极作用。

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