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安罗替尼联合抗程序性死亡蛋白1(PD-1)抑制剂用于晚期实体瘤二线及以上治疗的回顾性研究

A Retrospective Study of Anlotinib Combined with Anti-PD-1 Inhibitors in the 2nd or Later-Line Treatment of Advanced Solid Tumors.

作者信息

Li Shu-Hui, Li Yi-Wen, Li Ying-Jue, Liu Lin-Bo, Zhang Qun, Lu Dan

机构信息

Department of Oncology, The Second Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, 150086, People's Republic of China.

出版信息

Int J Gen Med. 2023 Oct 4;16:4485-4498. doi: 10.2147/IJGM.S426590. eCollection 2023.

Abstract

OBJECTIVE

To investigate the clinical efficacy and safety of anlotinib combined with anti-PD-1 inhibitors in the 2nd or later-line treatment of advanced solid tumors.

PATIENTS AND METHODS

A total of 63 patients with advanced solid tumors who had failed or could not endure the adverse reactions after receiving first-line or more systematic treatment in the Second Affiliated Hospital of Harbin Medical University from March 2019 to April 2023 were treated with anlotinib Hydrochloride capsule combined with anti-PD-1 inhibitors. The efficacy and adverse reactions were evaluated according to RECIST1.1 and NCICTC4.0 standards.

RESULTS

The percentage of overall response rate of 63 patients during the combination administration indicated that complete response was 1.6% (n=1), partial response was 23.8% (n=15), stable disease was 39.7% (n=25) and progressive disease was 34.9% (n=22), yielding objective response rate (ORR) of 25.4% and disease control rate (DCR) of 65.1%. Furthermore, the median PFS of 63 patients with advanced solid tumors was 7 months and the median OS was not reached, and the median follow-up time is 4.5 months. In subgroup analysis, there was no significant difference in PFS between first-line, second-line, third-line and above (p=0.631); there was no significant difference in PFS between PD-1 positive patients and PD-1 negative patients (p=0.094); there was no significant difference in PFS between patients who had previously used anti-PD-1 inhibitors and patients who had not used before (p=0.204). The most common adverse reactions were hypertension, hand-foot syndrome, and fatigue, with an incidence of 28.4% (18/63), 25.6% (14/63), and 25.6% (14/63), respectively. Most of the adverse reactions were grade 1-2, and there were no grade 4 adverse reactions.

CONCLUSION

Anlotinib combined with anti-PD-1 inhibitors demonstrated promising efficacy and tolerable safety for patients with advanced solid tumors in the 2nd or later-line treatment.

摘要

目的

探讨安罗替尼联合抗程序性死亡蛋白1(PD-1)抑制剂用于晚期实体瘤二线及以上治疗的临床疗效和安全性。

患者与方法

选取2019年3月至2023年4月在哈尔滨医科大学附属第二医院接受一线或更多线系统治疗后失败或无法耐受不良反应的63例晚期实体瘤患者,采用盐酸安罗替尼胶囊联合抗PD-1抑制剂进行治疗。根据实体瘤疗效评价标准(RECIST1.1)和美国国立癌症研究所常见毒性标准(NCICTC4.0)评估疗效和不良反应。

结果

63例患者联合用药期间的总缓解率百分比显示,完全缓解为1.6%(n = 1),部分缓解为23.8%(n = 15),病情稳定为39.7%(n = 25),疾病进展为34.9%(n = 22),客观缓解率(ORR)为25.4%,疾病控制率(DCR)为65.1%。此外,63例晚期实体瘤患者的中位无进展生存期(PFS)为7个月,中位总生存期(OS)未达到,中位随访时间为4.5个月。亚组分析显示,一线、二线、三线及以上治疗患者的PFS无显著差异(p = 0.631);PD-1阳性患者和PD-1阴性患者的PFS无显著差异(p = 0.094);既往使用过抗PD-1抑制剂的患者和未使用过的患者的PFS无显著差异(p = 0.204)。最常见的不良反应为高血压、手足综合征和疲劳,发生率分别为28.4%(18/63)、25.6%(14/63)和25.6%(14/63)。大多数不良反应为1-2级,无4级不良反应。

结论

安罗替尼联合抗PD-1抑制剂用于晚期实体瘤二线及以上治疗显示出有前景的疗效和可耐受的安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/498f/10560472/39f37c2008a7/IJGM-16-4485-g0001.jpg

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