二线单药化疗联合PD-1/PD-L1抑制剂对晚期非小细胞肺癌的临床疗效

目的探讨二线单药化疗联合程序性死亡受体(PD)-1/PD-L1抑制剂对晚期非小细胞肺癌(NSCLC)患者的临床疗效。方法前瞻性选取山东大学齐鲁医院于2018年12月至2020年3月收治的晚期NSCLC患者82例,采用随机数字表法分为观察组(n=41)与对照组(n=41)。对照组单用培美曲塞化疗治疗;观察组给予培美曲塞与纳武利尤单抗注射液联用治疗。比较2组患者化疗4个周期疗效;化疗前与化疗4个周期后Karnofsky功能状态评分(KPS)、肿瘤标志物糖类抗原125(CA125)和癌胚抗原(CEA)]和T淋巴细胞亚群变化以及化疗期间毒副作用情况。结果观察组患者经化疗4个周期总有效率(63.41%)高于对照组(41.47%),差异有统计学意义(P<0.05)。化疗前,2组患者KPS评分、血清CA125、CEA水平、CD3+、CD4+和CD4+/CD8+比较,差异无统计学意义(P>0.05);化疗4个周期后,观察组患者KPS评分(85.46±3.87)分高于对照组(78.29±3.42)分,差异有统计学意义(P<0.05)。化疗4个周期后,观察组患者血清CA125和CEA水平分别为(32.54±4.60)U/mL、(14.35±3.76)ng/mL,低于对照组(45.12±5.76)U/mL、(23.12±3.26)ng/mL],差异有统计学意义(P<0.05)。化疗4个周期后,观察组患者CD3+、CD4+和CD4+/CD8+分别为(56.57±3.08)%、(35.48±2.16)%、(1.42±0.19),高于对照组(48.72±3.25)%、(29.39±2.45)%和(0.89±0.14)],差异有统计学意义(P<0.05)。2组NSCLC患者化疗4个周期后期间不良反应比较,差异无统计学意义(P>0.05)。结论培美曲塞与纳武利尤单抗注射液联用对晚期NSCLC患者近期疗效良好,且可改善患者生存质量和免疫功能,降低CA125和CEA水平,毒副作用较轻。

Clinical efficacy of second-line single drug chemotherapy combined with PD-1/PD-L1 inhibitors in the treatment of advanced non-small cell lung cancer

Objective To investigate the clinical efficacy of second-line single drug chemotherapy combined with PD-1/PD-L1 inhibitors in patients with advanced non-small cell lung cancer(NSCLC).Methods Eighty-two patients with advanced NSCLC admitted to Qilu Hospital of Shandong University from December 2018 to March 2020 were prospectively selected and divided into observation group(n=41)and control group(n=41)by random number table.The control group was treated with pemetrexed alone,while the observation group was treated with pemetrexed combined with navulizumab injection.The efficacy of four cycles of chemotherapy for advanced NSCLC was compared between the two groups;Karnofsky functional status score(KPS),tumor markerscarbohydrate antigen 125(CA125)and carcinoembryonic antigen(CEA)]and T lymphocyte subsets before and after 4 cycles of chemotherapy;and the adverse reactions during chemotherapy were also compared.Results Four cycles of chemotherapy,the observation group effective(63.41%)was higher than control group(41.47%),the difference was statistically significant(P<0.05).Before chemotherapy,there was no significant difference in KPS score,serum CA125,CEA level,CD3+,CD4+and CD4+/CD8+between the two groups(P>0.05).After four cycles of chemotherapy,KPS score of the observation group were(85.46±3.87)pionts,which were higher than those of control group(78.29±3.42)points],the difference was statistically significant(P<0.05).After four cycles of chemotherapy,the serum CA125 and CEA levels of the observation group were(32.54±4.60)U/mL and(14.35±3.76)ng/mL,respectively,which were lower than those of the control group(45.12±5.76)U/mL,(23.12)±3.26)ng/mL],the difference was statistically significant(P<0.05).After four cycles of chemotherapy,the CD3+,CD4+and CD4+/CD8+of the observation group were(56.57±3.08)%,(35.48±2.16)%,(1.42±0.19),respectively,which were higher than those of the control group(48.72±3.25)%,(29.39±2.45)%and(0.89±0.14)],the difference was statistically significant(P<0.05).There was no significant difference in side effects between the two groups(P>0.05).Conclusion Pemetrexed combined with navulizumab injection has a good short-term effect on patients with advanced NSCLC,and can improve the quality of life and immune function of patients,reduce the levels of CA125 and CEA,with mild side effects.