PD-1抑制剂联合安罗替尼治疗晚期神经内分泌癌的疗效及安全性

目的 分析程序性死亡受体-1（PD-1）抑制剂联合安罗替尼治疗晚期神经内分泌癌的疗效及安全性。方法 收集郑州大学第一附属医院经一线标准化疗失败、应用PD-1抑制剂联合安罗替尼治疗的晚期神经内分泌癌患者资料。结果 共纳入45例患者，男性24例，女性21例；年龄42~84岁，中位年龄57岁。肿瘤原发部位：肺23例（51.1%）、食管8例（17.8%）、胰腺和直肠各7例（15.6%）。18例（40.0%）患者既往一线和二线治疗失败，27例（60.0%）患者三线及以上治疗失败。所有患者接受2~15周期的治疗，3例因疾病进展死亡，总体客观缓解率为11.1%，疾病控制率为53.5%，中位无进展生存期为5.8月，10月无进展生存率为25.5%。不良反应主要为1~2级骨髓抑制和消化道反应。结论 PD-1联合安罗替尼治疗晚期神经内分泌癌疗效较好，耐受性好，可作为晚期神经内分泌癌标准一线治疗失败后的选择。

Efficacy and Safety of PD-1 Inhibitor Combined with Anlotinib on AdvancedNeuroendocrine Carcinoma

Objective To analyze the efficacy and safety of PD-1 inhibitor combined with anlotinib on advanced neuroendocrine carcinoma. Methods We collected the data of patients with advanced neuroendocrine carcinoma who had failed the first-line standard chemotherapy and treated with PD-1 inhibitor combined with anlotinib from the First Affiliated Hospital of Zhengzhou University. Results A total of 45 patients, including 24 males and 21 females, were included. The median age was 57 years old. The primary tumor sites were lung (23 cases, 51.1%), esophagus (8 cases, 17.8%), pancreas (7 cases, 15.6%) and rectum (7 cases, 15.6%). Eighteen cases (40%) had failed the first- and second-line treatments, and 27 cases (60%) had failed the third-line and above treatments. All patients received 2-15 cycles of treatment, 3 cases died due to disease progression, overall objective response rate was 11.1%, disease control rate was 53.5%, median progression-free survival was 5.8 months, and 10-month progression-free survival rate was 25.5%. Adverse events were mainly grade 1-2 myelosuppression and digestive tract reactions. Conclusion PD-1 combined with anlotinib show better efficacy and good tolerance on advanced neuroendocrine carcinoma. It can be used as a choice after the failure of standard first-line treatment of advanced neuroendocrine carcinoma.