内皮抑素联合 PT-DC 与贝伐珠单抗联合 PT-DC 一线治疗晚期肺腺癌的比较：一项回顾性倾向评分匹配队列研究。

Comparison of endostatin combined with PT-DC versus bevacizumab combined with PT-DC in the first-line treatment of advanced lung adenocarcinoma: a retrospective propensity score-matched cohort study.

机构信息

Department of Thoracic Oncology II, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China.

出版信息

Ann Palliat Med. 2021 Jul;10(7):7847-7856. doi: 10.21037/apm-21-1401.

DOI:10.21037/apm-21-1401

PMID:34353072

Abstract

BACKGROUND

Endostatin and bevacizumab have been approved for the first-line treatment of advanced non-small-cell lung cancer (NSCLC) patients in China; however, the clinical outcomes for each drug combined with platinum-based doublet chemotherapy (PT-DC) have not yet been directly compared. This study sought to assess the clinical outcomes of the 2 drugs combined with PT-DC in the first-line treatment of patients with advanced lung adenocarcinoma.

METHODS

This retrospective cohort study examined the clinical data of patients with metastatic or recurrent lung adenocarcinoma (LUAD) treated with endostatin or bevacizumab combined with PT-DC as the first-line treatment from October 2010 to November 2019. Propensity score matching (PSM) was performed using a 1:1 ratio nearest neighbor algorithm. The effectiveness and safety outcomes for the 2 groups were evaluated.

RESULTS

A total of 202 patients were enrolled in the study. Of these, the endostatin group comprised 124 patients and the bevacizumab group comprised 78 patients; 67 pairs of patients were identified after PSM. The progression-free survival (PFS) and overall survival (OS) of patients treated with PT-DC + endostatin and PT-DC + bevacizumab were compared [(PFS: before PSM 4.8 vs. 6.5 months, P=0.741; after PSM 6.5 vs. 6.1 months, P=0.402), (OS: before PSM 21.1 vs. 39.3 months, P=0.912; after PSM 23.6 vs. 39.3 months, P=0.579)]. The objective response rates (ORRs) and disease control rates (DCRs) of the 2 groups were comparable (37.7% vs. 50.7%, P=0.094; 89.6% vs. 92.5%, P=0.545). Adverse events (AEs) ≥ grade 3 were not observed in the PT-DC + endostatin group. Three (3.8%) cases of AEs ≥ grade 3 were observed the PT-DC + bevacizumab group, comprising hypertension (n=1), proteinuria (n=1), hemoptysis (n=1).

CONCLUSIONS

This retrospective analysis showed that in first-line treatments, PT-DC + endostatin and PT-DC + bevacizumab appear to produce similar anti-tumor activities in patients with metastatic or recurrent lung adenocarcinoma. PT-DC + bevacizumab tended to result in worse adverse reactions than PT-DC + endostatin.

摘要

背景

恩度和贝伐珠单抗已在中国被批准用于晚期非小细胞肺癌（NSCLC）患者的一线治疗；然而，每种药物联合铂类双联化疗（PT-DC）的临床结果尚未进行直接比较。本研究旨在评估恩度和贝伐珠单抗联合 PT-DC 一线治疗晚期肺腺癌患者的临床结果。

方法

本回顾性队列研究纳入了 2010 年 10 月至 2019 年 11 月期间接受恩度或贝伐珠单抗联合 PT-DC 作为一线治疗的转移性或复发性肺腺癌（LUAD）患者的临床数据。采用 1:1 比例最近邻算法进行倾向评分匹配（PSM）。评估两组的有效性和安全性结局。

结果

共有 202 例患者入组本研究。其中，恩度组 124 例，贝伐珠单抗组 78 例；PSM 后共确定 67 对患者。PT-DC+恩度和 PT-DC+贝伐珠单抗治疗患者的无进展生存期（PFS）和总生存期（OS）结果比较如下：[（PFS：PSM 前 4.8 个月 vs. 6.5 个月，P=0.741；PSM 后 6.5 个月 vs. 6.1 个月，P=0.402），（OS：PSM 前 21.1 个月 vs. 39.3 个月，P=0.912；PSM 后 23.6 个月 vs. 39.3 个月，P=0.579）]。两组的客观缓解率（ORR）和疾病控制率（DCR）相当（37.7% vs. 50.7%，P=0.094；89.6% vs. 92.5%，P=0.545）。恩度组未观察到任何≥3 级的不良事件（AE）。贝伐珠单抗组观察到 3 例（3.8%）≥3 级的 AE，包括高血压（n=1）、蛋白尿（n=1）、咯血（n=1）。