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程序性细胞死亡蛋白-1(PD-1)抑制剂联合抗血管生成靶向药物作为晚期或转移性非小细胞肺癌(NSCLC)后续治疗的疗效和安全性。

Efficacy and safety profile of combining programmed cell death-1 (PD-1) inhibitors and antiangiogenic targeting agents as subsequent therapy for advanced or metastatic non-small cell lung cancer (NSCLC).

机构信息

Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

Thorac Cancer. 2021 Sep;12(17):2360-2368. doi: 10.1111/1759-7714.14078. Epub 2021 Jul 16.

Abstract

BACKGROUND

Previous studies have demonstrated that PD-1 inhibitors are effective in the treatment of advanced or metastatic non-small cell lung cancer (NSCLC). However, whether the combination of PD-1 inhibitors and antiangiogenic agents benefit advanced NSCLC patients as subsequent therapy remains unknown. In this study, we retrospectively reviewed the efficacy and safety profile of this combination strategy as subsequent therapy for NSCLC patients in a real-world setting.

METHODS

A total of 30 patients with advanced NSCLC, who progressed after at least two cycles of platinum-based chemotherapy or targeted therapy and subsequently received combination therapy with a PD-1 inhibitor and antiangiogenic agent, were included in this study. The safety profile and efficacy were also investigated.

RESULTS

At the time of a median follow-up period of 10.7 months, 28 patients had experienced progression of disease and 16 patients had died. The median progression-free survial (mPFS) was 5.0 months (95% confidence interval [CI]: 3.179-6.821), and the median overall survival (mOS) was 14.3 months (95% CI: 8.912-19.659). The objective response rate (ORR) and the disease control rate (DCR) were 10.3% and 72.4%, respectively (0 complete remission, three partial responses and 18 stable disease in 29 patients with measurable lesions). Patients with PD-L1 expression of at least 1% of tumor cells (n = 5) had relatively longer mPFS compared to those with PD-L1-negative tumors (n = 14), (11.6 months vs. 3.7 months). Treatment was suspended in two patients due to grade 3 immune-related pneumonia and pancreatitis, respectively. No novel adverse events (AEs) or grade 4 AEs were observed.

CONCLUSIONS

A combination of PD-1 inhibitors and antiangiogenic targeting agents may be beneficial for patients with advanced or metastatic NSCLC as subsequent treatment, especially for patients with PD-L1 protein expression positive, and treatment is well tolerated.

摘要

背景

先前的研究表明,PD-1 抑制剂在治疗晚期或转移性非小细胞肺癌(NSCLC)方面具有疗效。然而,作为后续治疗,PD-1 抑制剂与抗血管生成药物联合应用是否能使晚期 NSCLC 患者获益尚不清楚。在这项研究中,我们回顾性地评估了该联合策略作为晚期 NSCLC 患者真实世界环境下后续治疗的疗效和安全性。

方法

共纳入 30 例晚期 NSCLC 患者,这些患者在至少接受两个周期铂类化疗或靶向治疗后进展,随后接受 PD-1 抑制剂和抗血管生成药物联合治疗。同时也对安全性和疗效进行了评估。

结果

在中位随访 10.7 个月时,28 例患者发生疾病进展,16 例患者死亡。中位无进展生存期(mPFS)为 5.0 个月(95%置信区间 [CI]:3.179-6.821),中位总生存期(mOS)为 14.3 个月(95%CI:8.912-19.659)。客观缓解率(ORR)和疾病控制率(DCR)分别为 10.3%和 72.4%(29 例可测量病灶患者中,0 例完全缓解,3 例部分缓解,18 例稳定疾病)。肿瘤细胞 PD-L1 表达至少为 1%的患者(n=5)的 mPFS 相对较长,与 PD-L1 阴性肿瘤患者(n=14)相比(11.6 个月 vs. 3.7 个月)。两名患者分别因 3 级免疫相关性肺炎和胰腺炎而暂停治疗。未观察到新的不良反应(AE)或 4 级 AE。

结论

PD-1 抑制剂与抗血管生成靶向药物联合应用可能对晚期或转移性 NSCLC 患者作为后续治疗有益,特别是对 PD-L1 蛋白表达阳性的患者,且治疗耐受性良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc08/8410518/674d7b922b15/TCA-12-2360-g004.jpg

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