培美曲塞与贝伐单抗联合应用维持治疗晚期肺腺癌的临床疗效

目的观察贝伐单抗与培美曲塞联合应用维持治疗晚期肺腺癌的临床疗效及不良反应。方法收集54例驱动基因阴性晚期肺腺癌患者经一线培美曲塞+/-贝伐单抗+顺铂方案化疗4至6周期,获得疾病控制后,分为培美曲塞+贝伐单抗组和培美曲塞单药组,观察两组无进展生存期(PFS)、有效率及不良反应。同时,收集患者开始维持治疗前和维持治疗4周期后的空腹静脉血,应用ELISA法检测血管内皮生长因子(VEGF)水平,评估血清VEGF水平变化与疗效的相关性。结果两药组客观有效率(ORR)和疾病控制率(DCR)均显著高于单药组(P <0. 05或<0. 01)。两组中位PFS分别为7. 8和3. 9月,且两组PFS经Log-rank检验差异有统计学意义。维持治疗4周期后,与治疗前比较,两药联合应用组患者治疗后血清VEGF水平明显下降(P <0. 01);与单药组比较,两药组患者治疗后血清VEGF水平明显下降(P <0. 01)。结论培美曲塞与贝伐单抗两药联合应用维持治疗晚期肺腺癌近期疗效更加显著,有较好的有效性和安全性,值得临床推广使用。同时,动态监测血清VEGF表达水平可有效预测抗肿瘤治疗疗效...

The clinical efficacy of bevacizumab combined with pemetrexed in the maintenance treatment of advanced lung adenocarcinoma

Objective To observe the clinical efficacy and side effects of pemetrexed combined with bevacizumab in the maintenance treatment of advanced lung adenocarcinoma.Methods Fifty-four patients with driver gene negative advanced lung adenocarcinoma received 4-6 cycles of first-line pemetrexed +/- bevacizumab + cisplatin chemotherapy. After the disease was controlled, they were divided into the pemetrexed + bevacizumab + cisplatin group and pemetrexed monotherapy group, and then the PFS, effective rate and adverse reactions of the two groups were observed. At the same time, fasting venous blood of patients before maintenance treatment and after 4 cycles of maintenance treatment was collected, and the vascular endothelial growth factor (VEGF) level was detected by ELISA to evaluate the correlation between changes in serum VEGF level and the efficacy.Results Both ORR and DCR of the two drug groups were significantly higher than those of the single drug group (P<0.05 or <0.01). The median PFS of two groups were 7.8 and 3.9 months and there was statistically significant difference between the two groups by log-rank test. After 4 cycles of maintenance treatment, the serum VEGF level of patients in the two groups significantly decreased after treatment, compared with VEGF level before treatment (P<0.01); compared with the single drug group, the serum VEGF level of patients in the two drug groups decreased significantly after treatment (P<0.01).Conclusion The combination of pemetrexed and bevacizumab in the maintenance treatment of advanced lung adenocarcinoma is more effective in the near term, with better efficacy and safety, and is worthy of clinical promotion. Meanwhile, dynamic monitoring of serum VEGF expression level can effectively predict the efficacy of anti-tumor therapy and is convenient and non-invasive.