安罗替尼联合PD-1抑制剂二线治疗老年晚期肺腺癌患者的疗效及对T淋巴细胞亚群的影响
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1.南京医科大学附属肿瘤医院&2.江苏省肿瘤医院&3.江苏省肿瘤防治研究所

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江苏省肿瘤医院面上项目(编号:ZM201808); 中华国际医学交流基金会(编号:Z-2014-06-2103);江苏省肿瘤医院科技发展基金(编号:ZJ202110)


Efficacy of Anlotinib combined with PD-1 inhibitor in the second-line treatment of elderly patients with advanced lung adenocarcinoma and its effect on T lymphocyte subsets
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1.The Affiliated Cancer Hospital of Nanjing Medical University&2.Jiangsu Cancer Hospital &3.Jiangsu Institute of Cancer Research

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    摘要:

    目的:探讨安罗替尼联合PD-1单抗在无驱动基因突变的老年晚期肺腺癌患者二线治疗中的疗效及对患者T淋巴细胞亚群的影响。方法:给予无驱动基因突变的老年晚期肺腺癌患者每三周一次帕博利珠单抗联合安罗替尼治疗,或每两周一次纳武利尤单抗联合安罗替尼治疗,采用实体瘤疗效评定1.1标准进行疗效评价,直至患者出现病情进展或治疗不耐受。采用流式细胞术检测患者治疗前后外周血中T淋巴细胞亚群的变化情况,同时监测患者的不良反应。结果:本方案客观缓解率为28.1%,疾病控制率为87.5%;总体中位无进展生存时间为6.2个月。治疗2周期后CD3+,CD4+,CD4+/CD8+细胞水平明显高于治疗前,CD8+细胞水平明显低于治疗前(P<0.01)。结论:安罗替尼联合PD-1单抗免疫治疗在无驱动基因突变的老年肺腺癌患者的二线治疗中,可提高近期疗效,延长无进展生存期,并且有助于患者免疫功能恢复,改善生活质量,在临床中具有良好的运用前景。

    Abstract:

    Objective: To investigate the efficacy of Anlotinib combined with PD-1 inhibitor in the second-line treatment of elderly patients with advanced lung adenocarcinoma without driver gene mutation and its effect on T lymphocyte subsets. Methods: Elderly patients with advanced lung adenocarcinoma without driver gene mutation were given Pembrolizumab q3w combined with Anlotinib, or Nivolumab q2w combined with Anlotinib. The efficacy was evaluated by solid tumor RECIST 1.1 standard until the patient had disease progression or treatment intolerance. The changes of T lymphocyte subsets in peripheral blood before and after treatment were detected by flow cytometry, and the adverse reactions were monitored. Results: The objective remission rate was 28.1% and the disease control rate was 87.5%; The overall median PFS was 6.2 months. After 2 cycles of treatment, the levels of CD3+, CD4+, CD4+/CD8+cells were significantly higher than those before treatment, and the levels of CD8+ cells were significantly lower than those before treatment (P < 0.01). Conclusion: In the second-line treatment of elderly patients with lung adenocarcinoma without driver gene mutation, Anlotinib combined with PD-1 immunotherapy can improve the short-term efficacy, prolong the progression free survival, help the recovery of immune function and improve the quality of life, and has a good prospect in clinical application.

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  • 收稿日期:2022-04-21
  • 最后修改日期:2023-01-17
  • 录用日期:2023-04-17
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