安罗替尼联合多西他赛二线治疗无驱动基因晚期非小细胞肺癌的临床疗效观察

目的 观察盐酸安罗替尼联合多西他赛二线治疗无驱动基因突变的晚期非小细胞肺癌(NSCLC)患者的临床疗效和安全性,为无驱动基因突变的晚期NSCLC患者二线治疗提供理论依据和治疗策略。 方法 收集蚌埠医学院第一附属医院2018年5月—2019年5月期间收治的一线治疗进展并选择盐酸安罗替尼联合多西他赛作为二线治疗方案的无驱动基因突变的晚期NSCLC患者共36例,分析盐酸安罗替尼联合多西他赛二线治疗的临床疗效,评价安全性与不良反应发生情况。 结果 盐酸安罗替尼联合多西他赛二线治疗无驱动基因突变的晚期NSCLC患者的中位无进展生存期(mPFS)为4.5个月(1.5~15.4个月),其中完全缓解(CR)0例,部分缓解(PR)6例,疾病稳定(SD)25例,疾病进展(PD)5例。疾病控制率(DCR)为86.11%,客观缓解率(ORR)为16.67%。在疾病得到控制的31例患者中,20例患者在观察期内再次出现进展。Cox多因素分析显示:肿瘤分期是影响预后的独立危险因素(P=0.032)。常见不良反应有高血压、乏力、肝功能异常、手足综合征等。 结论 盐酸安罗替尼联合多西他赛二线治疗无驱动基因突变的晚期NSCLC患者疗效肯定,不良反应发生率较低,可作为无驱动基因突变晚期NSCLC患者一线治疗进展后的治疗选择。 

Clinical observation of second-line treatment of anlotinib combined with docetaxel on advanced non-small cell lung cancer without driver gene mutation

Objective To observe the clinical efficacy and safety of anlotinib combined with docetaxel as the second-line therapy for patients with advanced non-small cell lung cancer(NSCLC) without driver gene mutation, and to provide theoretical basis and therapeutic strategy. Methods Thirty-six patients were selected from May 2018 to May 2019 in the First Affiliated Hospital of Bengbu Medical College. These patients were treated with anlotinib combined with docetaxel in second-line therapy of advanced NSCLC without driver gene mutation who had failed in first-line therapy. The clinical efficacy, safety and adverse reactions were evaluated. Results The median progression-free survival of anlotinib combined with docetaxel was 4.5 months(ranging from 1.5 months to 15.4 months). After treatment, the number of CR, PR, SD and PD was 0, 6, 25, 5 respectively, and DCR and ORR were 86.11% and 16.67% respectively. In 31 patients with controlled diseases, 20 patients made progress again during the observation period. Cox multivariate analysis showed that staging was an independent risk factor for prognosis(P=0.032). Common adverse reactions included hypertension, fatigue, abnormal liver function, hand-foot syndrome, etc. Conclusion The efficacy of anlotinib combined with docetaxel as second-line therapy for patients with advanced NSCLC without driver gene mutation is positive, and the incidence of adverse reactions are tolerable. This therapy can be used as second-line treatment option for advanced NSCLC patients without gene mutation.