Page 112 - 南京医科大学学报自然科学版

南京医科大学学报（自然科学版） 第43卷第4期
·550 · Journal of Nanjing Medical University（Natural Sciences） 2023年4月

·临床研究·

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

晏 芾，滕 悦，俞心念，石 林，武 渊 *

江苏省肿瘤医院（南京医科大学附属肿瘤医院）肿瘤内科，江苏省肿瘤防治研究所，江苏 南京 210009

［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3周1次帕博利珠单抗联合安罗替尼治疗，或每2周
1 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个周期后CD3 、CD4 细胞水平及CD4 /CD8 明显
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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
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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
好的应用前景。
［关键词］ 非小细胞肺癌；安罗替尼；免疫检查点抑制剂；T淋巴细胞亚群
［中图分类号］ R734.2 ［文献标志码］ A ［文章编号］ 1007⁃4368（2023）04⁃550⁃05
doi：10.7655/NYDXBNS20230415

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
*
YAN Fei，TENG Yue，YU Xinnian，SHI Lin，WU Yuan
Internal Medicine Oncology，Jiangsu Cancer Hospital，the Affiliated Cancer Hospital of Nanjing Medical University，
Jiangsu Institute of Cancer Research，Nanjing 210009，China

［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 response evaluation criteria in solid tumors（RECIST）1.1 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 progression free survival was 6.2 months. After two cycles of treatment，the
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levels of CD3 ，CD4 ，CD4 /CD8 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，which has a good prospect in clinical
application.
［Key words］ non⁃small cell lung cancer；anlotinib；immune checkpoint inhibitor；T lymphocyte subset
［J Nanjing Med Univ，2023，43（04）：550⁃554］

［基金项目］ 中华国际医学交流基金会（Z-2014-06-2103）；江苏省肿瘤医院面上项目（ZM201808）；江苏省肿瘤医院科技发展
基金（ZJ202110）
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通信作者（Corresponding author），E⁃mail：513454087@qq.com