Pan Dengdeng, Liu Dongliang, Liang Lichuan, Shen Tongyi, Shi Chenzhang, Qin Huanlong
Department of General Surgery, Anhui Medical University, Hefei, China.
Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Front Oncol. 2022 May 19;12:863392. doi: 10.3389/fonc.2022.863392. eCollection 2022.
Programmed cell death protein 1 (PD-1) inhibitor plus apatinib is reported to be a promising strategy for advanced cancers. Moreover, a PD-1 inhibitor or apatinib exerts a certain efficacy in advanced colorectal cancer (CRC), whereas their synergistic effect is unclear. This study aimed to evaluate the treatment efficacy and safety of a PD-1 inhibitor plus apatinib in advanced CRC patients.
In total, 45 advanced CRC patients who received a PD-1 inhibitor plus apatinib (PD-1 inhibitor plus apatinib group, N=20) or apatinib monotherapy (apatinib group, N=25) as third-line therapies were enrolled in the current study.
The objective response rate (20.0% vs. 8.0%) (=0.383) and disease control rate (70.0% vs. 52.0%) (=0.221) were numerically increased in the PD-1 inhibitor plus apatinib group, respectively, compared with the apatinib group, but no statistical significance was observed. The median progression-free survival (PFS) was 7.5 versus 4.8 months; the 1-year PFS rate was 32.5% versus 9.9%; the median overall survival (OS) was 12.3 versus 8.7 months; and the 1-year OS rate was 50.7% versus 27.0% in the PD-1 inhibitor plus apatinib group versus the apatinib group, respectively. PFS (=0.038) and OS (=0.048) were prolonged in the PD-1 inhibitor plus apatinib group compared with the apatinib group. PD-1 inhibitor plus apatinib (versus apatinib) was independently associated with longer PFS (=0.012) and OS (=0.009). The majority of the adverse events were of grade 1-2, wherein the incidence was similar between groups, except for the fact that the incidence of capillary proliferation was elevated in the PD-1 inhibitor plus apatinib group compared with the apatinib group (25.5% versus 0.0%) (=0.013).
PD-1 inhibitor plus apatinib presents a potential improvement in efficacy and survival benefit compared with apatinib monotherapy, with tolerable safety in advanced CRC patients.
据报道，程序性细胞死亡蛋白1（PD-1）抑制剂联合阿帕替尼是治疗晚期癌症的一种有前景的策略。此外，PD-1抑制剂或阿帕替尼在晚期结直肠癌（CRC）中具有一定疗效，但其协同作用尚不清楚。本研究旨在评估PD-1抑制剂联合阿帕替尼治疗晚期CRC患者的疗效和安全性。
本研究共纳入45例接受PD-1抑制剂联合阿帕替尼（PD-1抑制剂联合阿帕替尼组，N=20）或阿帕替尼单药治疗（阿帕替尼组，N=25）作为三线治疗的晚期CRC患者。
与阿帕替尼组相比，PD-1抑制剂联合阿帕替尼组的客观缓解率（分别为20.0%对8.0%）（P=0.383）和疾病控制率（分别为70.0%对52.0%）（P=0.221）在数值上有所提高，但未观察到统计学意义。中位无进展生存期（PFS）分别为7.5个月和4.8个月；1年PFS率分别为32.5%和9.9%；中位总生存期（OS）分别为12.3个月和8.7个月；PD-1抑制剂联合阿帕替尼组与阿帕替尼组的1年OS率分别为50.7%和27.0%。与阿帕替尼组相比，PD-1抑制剂联合阿帕替尼组的PFS（P=0.038）和OS（P=0.048）延长。PD-1抑制剂联合阿帕替尼（对比阿帕替尼）与更长的PFS（P=0.012）和OS（P=0.009）独立相关。大多数不良事件为1-2级，除PD-1抑制剂联合阿帕替尼组的毛细血管增生发生率高于阿帕替尼组（25.5%对0.0%）（P=0.013）外，两组发生率相似。
与阿帕替尼单药治疗相比，PD-1抑制剂联合阿帕替尼在疗效和生存获益方面有潜在改善，且在晚期CRC患者中安全性可耐受。
