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贝伐珠单抗联合卡铂加白蛋白紫杉醇治疗真实世界中非鳞状非小细胞肺癌。

Bevacizumab Plus Carboplatin Plus Nab-paclitaxel for Non-squamous Non-small Cell Lung Cancer in a Real-world Setting.

机构信息

Department of Internal Medicine, Kinki-Chuo Chest Medical Center, Sakai, Japan.

Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka, Japan;

出版信息

Anticancer Res. 2023 Mar;43(3):1325-1330. doi: 10.21873/anticanres.16280.

Abstract

BACKGROUND/AIM: Regimens with bevacizumab (Bev) have high response rates. We previously showed the efficacy of Bev plus carboplatin (CBDCA)/nab-paclitaxel (nab-PTX) in the treatment of non-squamous (non-SQ) non-small lung cell cancer (NSCLC) with malignant pleural effusion in a phase II trial. However, few studies have reported the efficacy and safety of this regimen. Therefore, we conducted a retrospective analysis of the efficacy and safety of Bev plus CBDCA/nab-PTX for patients with NSCLC.

PATIENTS AND METHODS

We included patients with non-SQ NSCLC that underwent any number of treatment lines. Patients received a maximum of six cycles of Bev plus CBDCA/nab-PTX every three to four weeks followed by Bev plus nab-PTX every three to four weeks without disease progression or severe toxicities. The administration dose was left to the discretion of the attending physician.

RESULTS

We enrolled 48 patients treated with Bev plus CBDCA/nab-PTX between June 2015 and August 2021. The best response rate was 56.3% and the disease control rate was 79.2%. Twenty-three patients received maintenance therapy. Median progression-free and overall survival times were 6.8 and 10.4 months, respectively. Common adverse events included hematological toxicities, including ≥grade 3 neutropenia and neurosensory toxicity. One patient experienced severe bleeding events (grade 3 gastrointestinal bleeding) and another experienced grade 5 toxicity (infection).

CONCLUSION

The combination of Bev plus CBDCA/nab-PTX showed good efficacy with acceptable toxicities in non-SQ NSCLC patients, despite the inclusion of patients with late treatment lines and poor performance status.

摘要

背景/目的:贝伐珠单抗(Bev)方案具有较高的缓解率。我们之前的一项Ⅱ期临床试验结果显示,贝伐珠单抗联合卡铂(CBDCA)/白蛋白紫杉醇(nab-PTX)方案治疗伴有恶性胸腔积液的非鳞状(非-SQ)非小细胞肺癌(NSCLC)患者具有疗效。然而,鲜有研究报道该方案的疗效和安全性。因此,我们对贝伐珠单抗联合 CBDCA/nab-PTX 方案治疗 NSCLC 患者的疗效和安全性进行了回顾性分析。

患者和方法

纳入接受过任意线数治疗的非-SQ NSCLC 患者。患者每 3-4 周接受最多 6 个周期的贝伐珠单抗联合 CBDCA/nab-PTX 治疗,随后每 3-4 周接受贝伐珠单抗联合 nab-PTX 治疗,直至疾病进展或出现严重毒性。药物剂量由主管医生决定。

结果

我们共纳入 48 例接受贝伐珠单抗联合 CBDCA/nab-PTX 治疗的患者,治疗时间为 2015 年 6 月至 2021 年 8 月。最佳缓解率为 56.3%,疾病控制率为 79.2%。23 例患者接受了维持治疗。中位无进展生存期和总生存期分别为 6.8 个月和 10.4 个月。常见的不良反应包括血液学毒性,包括≥3 级中性粒细胞减少和神经感觉毒性。1 例患者发生严重出血事件(3 级胃肠道出血),1 例患者发生 5 级毒性(感染)。

结论

尽管纳入了治疗线数较晚、体能状态较差的患者,贝伐珠单抗联合 CBDCA/nab-PTX 方案在非-SQ NSCLC 患者中仍具有较好的疗效,且毒性可耐受。

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