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免疫检查点抑制剂联合化疗在非小细胞肺癌中的疗效及其对不良反应和血清肿瘤标志物的影响。

Efficacy of immune checkpoint inhibitors along with chemotherapy in non-small cell lung cancer and the impact on adverse reactions and serum tumor markers.

作者信息

Xie Miao, Wang Xinlin, Wang Peng, Liu An, Wen Yurong, Xiao Bing

机构信息

Geriatric Respiratory Department, Xi'an International Medical Center Hospital No. 777 Xitai Road, High Tech Zone, Xi'an 710075, Shaanxi, China.

Interventional Oncology Department, The Third People's Hospital of Gansu Province No. 763 Jiatan Road, Chengguan District, Lanzhou 730000, Gansu, China.

出版信息

Am J Transl Res. 2023 Aug 15;15(8):5276-5283. eCollection 2023.

Abstract

OBJECTIVE

To examine the efficacy of immune checkpoint inhibitors along with chemotherapy in non-small cell lung cancer (NSCLC) and the effect on adverse reactions and serum tumor markers.

METHODS

Data of 112 NSCLC patients admitted to Geriatric respiratory department, Xi'an International Medical Center Hospital from February 2018 to March 2021 were analyzed retrospectively. Among them, 54 patients treated with concurrent chemotherapy were labeled as the control group (CG), and 58 patients treated with PD-1/PD-L1 inhibitors in addition to chemotherapy were the observation group (OG). The two groups were compared in terms of immune function indexes, therapeutic efficacy, incidence of adverse reactions, 1-year survival rate, serum tumor markers before and after treatment, and independent risk factors affecting patients' prognosis.

RESULTS

Compared to the CG, the OG exhibited significantly better therapeutic efficacy. The levels of IgG, IgA and IgM 6 months after treatment were significantly higher in both groups than those before treatment, and the elevations in the OG were more evident than those in the CG, and the OG demonstrated markedly lower Recombinant Cytokeratin Fragment Antigen 21-1 (CYFRA21-1), Carcinoembryonic antigen (CEA) and Carbohydrate antigen 125 (CA125) levels after treatment than the CG did. Between the two groups, there was no significant difference identified in the incidence of adverse reactions, but the OG was observed to have much higher 1-year survival rate. The pathological stage, differentiation and treatment regimen were independent risk factors affecting patients' prognosis.

CONCLUSION

For NSCLC patients, the adoption of PD-1/PD-L1 inhibitors following chemoradiotherapy shows potential in enhancing clinical efficacy, boosting patients' immune function, and improving long-term survival rates, with premising safety profile.

摘要

目的

探讨免疫检查点抑制剂联合化疗治疗非小细胞肺癌(NSCLC)的疗效以及对不良反应和血清肿瘤标志物的影响。

方法

回顾性分析2018年2月至2021年3月在西安国际医学中心医院老年呼吸科收治的112例NSCLC患者的数据。其中,54例接受同步化疗的患者被标记为对照组(CG),58例在化疗基础上接受PD-1/PD-L1抑制剂治疗的患者为观察组(OG)。比较两组的免疫功能指标、治疗效果、不良反应发生率、1年生存率、治疗前后的血清肿瘤标志物以及影响患者预后的独立危险因素。

结果

与CG组相比,OG组的治疗效果明显更好。两组治疗后6个月的IgG、IgA和IgM水平均显著高于治疗前,且OG组的升高更为明显,OG组治疗后的重组细胞角蛋白片段抗原21-1(CYFRA21-1)、癌胚抗原(CEA)和糖类抗原125(CA125)水平明显低于CG组。两组之间不良反应发生率无显著差异,但观察到OG组的1年生存率高得多。病理分期、分化程度和治疗方案是影响患者预后的独立危险因素。

结论

对于NSCLC患者,放化疗后采用PD-1/PD-L1抑制剂在提高临床疗效、增强患者免疫功能和改善长期生存率方面具有潜力,且安全性良好。

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