帕博利珠单抗二线治疗含铂化疗进展的驱动基因阴性NSCLC的临床研究

doi:10.3969/j.issn.1006-6233.2021.12.034

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Abstract Objective: To study the curative effect and adverse reactions of immune checkpoint inhibitor (ICI) pembrolizumab (pembrolizumab) in the second-line treatment on patients of advanced non-small cell lung cancer (non-small cell lung cancer, NSCLC), and guide its clinical treatment. Methods: The medical records of 7838 patients with advanced NSCLC admitted to our hospital from January 2018 to April 2021 were collected. After standardized screening, the pathological data of 104 patients were finally included, and 104 cases were divided, according to different treatment plans, into study group (n=51) and control group (n=53). The study group was treated with pembrolizumab, and the control group were treated with docetaxel. The objective response rate (ORR), disease control rate (DCR), median progression-free survival (mPFS) and adverse events rate (adverse events rate) of the two groups were compared. Results: Compared with the control group, the DCR (90.2%) of the study group was significantly improved, with statistical difference (χ²=4.803, P=0.028). Compared with the control group, the median PFS (5.2 months) of the study group was significantly longer, but the difference was not statistically significant (χ²=3.560, P=0.059). Compared with the sub group with TPS 1~49%, the median PFS (6.0 months) of the subgroup with TPS≥50% in the study group was significantly longer, with statistical difference (χ²=4.223, P=0.040). In the subgroup for TPS≥50%, the median PFS (6.0 months) of the study group was significantly longer than that of the control group, with statistical difference (χ²=5.207, P=0.023). Compared with the control group, the incidence of immune pneumonia in the study group was higher with statistical difference (χ²=4.630, P=0.031). Conclusion: Pembrolizumab may have better short-term and long-term efficacy in patients with advanced NSCLC who have negative driver genes after the progression of platinum-containing chemotherapy, and for patients with PD-L1 TPS≥50%, pembrolizumab may be more effective, but at the same time attention should be paid to possible immune-related adverse reactions.

Key words： Non-small cell lung cancer PD-1 inhibitors Pembrolizumab Docetaxel

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2021.12.034 OR http://www.hbyxzzs.cn/EN/Y2021/V27/I12/2090

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