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| 免疫跨线白蛋白结合型紫杉醇对比安罗替尼联合白蛋白结合型紫杉醇二线治疗晚期肺腺癌的疗效及生存预后分析 |
| Analysis of efficacy and survival prognosis of second-line treatment of advanced lung adenocarcinoma with immune cross-line albumin-conjugated paclitaxel versus amilorotinib combined with albumin-conjugated paclitaxel |
| 投稿时间：2023-11-06 修订日期：2024-01-17 |
| DOI： |
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| 中文关键词: 晚期肺腺癌 二线治疗,免疫跨线 免疫检查点抑制剂 安罗替尼 |
| 英文关键词:Advanced lung adenocarcinoma second-line treatment immune cross-line immune checkpoint inhibitor androtinib |
| 基金项目: |
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| 摘要点击次数: 66 |
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| 中文摘要: |
| [目的] 本研究评估一线治疗中免疫检查点抑制剂（immune checkpoint inhibito,ICI）联合化疗后出现进展的晚期肺腺癌患者，在二线治疗中应用免疫跨线联合化疗对比多靶点血管生成抑制剂（安罗替尼）联合化疗的临床疗效，进一步寻找免疫联合化疗进展后二线中更好的联合治疗方案以及各方案的优势人群。[方法] 回顾性分析徐州医科大学附属医院自2020年1月至2023年5月收治的一线治疗中ICI联合化疗进展后的80例驱动基因阴性的晚期肺腺癌患者为研究对象，根据接受的治疗方案不同，将患者分为免疫跨线联合化疗组（组A，n=42）、安罗替尼联合化疗组（组B，n=38）。Cox比例风险回归模型和 Kaplan-Meier (KM) 曲线用于评估治疗方案与无进展生存期 (progression-free survival,PFS) 和总生存期 (overall survival,OS) 之间的联系，通过亚组分析评估治疗方案与疾病进展之间的关联。[结果] 组A和组B的客观缓解率（objective response rate,ORR）分别为23.81%和39.47%（P>0.05），疾病控制率（disease control rate, DCR）分别为59.52%和84.21%（P＜0.05）。两组患者的中位无进展生存时间（median progression-free survival,mPFS）分别为6.3个月和7.7个月(P＜0.05)，中位总生存时间（median overall survival, mOS）分别为11.5个月和14.5个月(P＜0.05)。两组常见不良反应为食欲减退、皮疹、腹泻，最严重的不良事件为甲状腺功能异常，经对症处理均可耐受，且未发生致死性事件。[结论] 一线免疫联合化疗进展后驱动基因阴性的晚期肺腺癌患者的二线治疗中，在整体人群的临床疗效中安罗替尼联合化疗优于免疫跨线联合化疗，在亚组分析中免疫跨线联合化疗组及安罗替尼联合化疗组各有各自的优势人群，临床疗效确切，且不良反应患者可耐受。 |
| 英文摘要: |
| [Objective] This study evaluates the clinical efficacy of applying immune cross-line combination chemotherapy compared with multi-targeted angiogenesis inhibitor (anilotinib) combination chemotherapy in second-line treatment for advanced lung adenocarcinoma patients who have progressed after immune checkpoint inhibitor (immune checkpoint inhibitor,ICI) combination chemotherapy in first-line treatment, to further search for a better combination treatment regimen in the second-line after progression of immune combination chemotherapy as well as the advantageous populations of each regimen. [Methods] Eighty driver gene-negative advanced lung adenocarcinoma patients admitted to the Affiliated Hospital of Xuzhou Medical University from January 2020 to May 2023 after progression of ICI combination chemotherapy in the first line of treatment were retrospectively analyzed as the study subjects, and the patients were divided into the immuno-cross-line combination chemotherapy group (Group A, n=42), and the amlotinib combination chemotherapy group (Group B, n=38), according to the different treatment regimens received. Cox proportional risk regression model and Kaplan-Meier (KM) curve were used to assess the association between treatment regimen and progression-free survival (PFS) and overall survival (OS), and the association between treatment regimen and disease progression was assessed by subgroup analysis. The association between treatment regimen and disease progression was assessed by subgroup analysis. [The objective response rate (ORR) was 23.81% and 39.47% (P>0.05), and the disease control rate (DCR) was 59.52% and 84.21% (P<0.05) in Group A and Group B, respectively.) The median progression-free survival (mPFS) was 6.3 and 7.7 months (P < 0.05), and the median overall survival (mOS) was 11.5 and 14.5 months (P < 0.05), respectively. 0.05). The common adverse events in both groups were loss of appetite, rash, diarrhea, and the most serious adverse event was thyroid function abnormality, which was tolerated with symptomatic treatment and no lethal events occurred. [Conclusion] In the second-line treatment of advanced lung adenocarcinoma patients with driver-negative genes after progression of first-line immune-combination chemotherapy, amilorotinib combination chemotherapy was superior to immune-spanning combination chemotherapy in the overall population, and in the subgroup analysis of immune-spanning combination chemotherapy and amilorotinib combination chemotherapy groups each had their own advantageous populations, with precise clinical efficacy and tolerable adverse events. |
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