Yang Xiaozun, Li Xin, Huang Ke, Zhuang Xiang
Department of Thoracic Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan 610000, P.R. China.
Department of Medical Oncology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan 610000, P.R. China.
Oncol Lett. 2024 Nov 12;29(1):53. doi: 10.3892/ol.2024.14799. eCollection 2025 Jan.
Driver gene-negative advanced-stage lung adenocarcinoma is associated with a poor prognosis and insufficient treatment options. The present study aimed to evaluate the efficacy and safety profile of a programmed cell death protein 1/programmed death-ligand 1 inhibitor plus bevacizumab and chemotherapy (PBC) regimen for the treatment of patients with driver gene-negative advanced-stage lung adenocarcinoma under real-world clinical conditions. Data from 65 patients with advanced-stage lung adenocarcinoma without sensitizing epidermal growth factor receptor, ALK receptor tyrosine kinase or ROS proto-oncogene 1 receptor tyrosine kinase mutations who received a PBC regimen or only a BC regimen were reviewed in the present retrospective cohort study. The results revealed that the objective response rate was higher (70.4 vs. 47.4%; P=0.065) in the PBC group compared with that in the BC group, while not reaching statistical significance. Progression-free survival (PFS) time was longer in the PBC group than in the BC group [median PFS: 10.8 months (95% confidence interval (CI), 7.2-14.4) vs. 7.6 months (95% CI, 5.0-10.2); P=0.016], while overall survival (OS) exhibited a non-significant trend to be longer in the PBC group compared with that in the BC group [median OS: 20.6 months (95% CI, 16.8-24.4) vs. 15.9 months (95% CI, 11.8-20.0); P=0.115]. Following adjustment by multivariate Cox analysis, the PBC (vs. BC) regimen was found to be independently associated with an improved PFS time (P=0.045). The common adverse events in the PBC group were neutropenia, alopecia, leukopenia, nausea and vomiting, fatigue, anemia and peripheral neuropathy. Moreover, the incidence of each adverse event did not differ significantly between the PBC and BC groups. In conclusion, the present study demonstrated that the PBC regimen serves as a superior treatment option for patients with driver gene-negative advanced-stage lung adenocarcinoma; however, further verification of its efficacy is still required.
驱动基因阴性的晚期肺腺癌预后较差且治疗选择有限。本研究旨在评估程序性细胞死亡蛋白1/程序性死亡配体1抑制剂联合贝伐单抗及化疗（PBC）方案在真实世界临床条件下治疗驱动基因阴性的晚期肺腺癌患者的疗效和安全性。在这项回顾性队列研究中，我们回顾了65例无敏感表皮生长因子受体、ALK受体酪氨酸激酶或ROS原癌基因1受体酪氨酸激酶突变的晚期肺腺癌患者的数据，这些患者接受了PBC方案或仅接受了BC方案。结果显示，PBC组的客观缓解率高于BC组（70.4% 对47.4%；P=0.065），但未达到统计学意义。PBC组的无进展生存期（PFS）长于BC组[中位PFS：10.8个月（95%置信区间（CI），7.2 - 14.4）对7.6个月（95%CI，5.0 - 10.2）；P=0.016]，而总生存期（OS）在PBC组较BC组有延长的趋势，但无统计学意义[中位OS：20.6个月（95%CI，16.8 - 24.4）对15.9个月（95%CI，11.8 - 20.0）；P=0.115]。经多变量Cox分析调整后，发现PBC（对比BC）方案与改善的PFS时间独立相关（P=0.045）。PBC组常见的不良事件有中性粒细胞减少、脱发、白细胞减少、恶心呕吐、疲劳、贫血和周围神经病变。此外，PBC组和BC组各不良事件的发生率无显著差异。总之，本研究表明PBC方案是驱动基因阴性的晚期肺腺癌患者的一种较好的治疗选择；然而，仍需进一步验证其疗效。
