贝伐珠单抗联合含铂化疗方案一线治疗晚期非鳞NSCLC疗效分析被引量：5

Combination of bevacizumab and platinum-based chemotherapy as first-line therapy for advanced non-squamous NSCLC

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摘要目的观察贝伐珠单抗联合含铂化疗方案一线治疗晚期非鳞非小细胞肺癌的疗效和安全性。方法经病理证实的55例晚期非鳞非小细胞肺癌采用贝伐珠单抗联合化疗作为一线治疗。贝伐珠单抗按7.5 mg/kg剂量在化疗第1天给予,每21天重复,至不能耐受或疾病进展。联合的一线化疗方案包括：培美曲塞加铂类（顺铂、卡铂或奈达铂）（培美曲塞组,n=41）或紫杉类加卡铂（紫杉类组,n=14）。每治疗2周期进行CT或MRI检查评价疗效并记录不良反应。结果 55例患者中无完全缓解病例,部分缓解33例,疾病稳定20例,疾病进展2例。疾病总有效率60.0%（33/55）,疾病控制率96.4%（53/55）,中位PFS为7.2月（1.7-31.5月,95%CI：6.0～8.4）。紫杉类组的中位PFS有优于培美曲塞组的趋势（8.5月vs 6.5月）,但差异无统计学意义（P=0.058）。培美曲塞组中位治疗周期数少于紫杉类组（4周期vs 9周期,P=0.000）。以顺铂为基础化疗患者（n=21）的有效率高于以卡铂为基础化疗的患者（n=31）（81.0%vs 51.6%,χ2=4.65,P=0.031）。不良反应方面,有2例出现大咯血,1例出现3级高血压,1例出现亚急性多发性脑梗死而停药,其余不良反应均为1～2级,可耐受。贝伐珠单抗联合顺铂或卡铂组引起不良反应相似。结论贝伐珠单抗联合含铂化疗方案一线治疗晚期非鳞非小细胞肺癌患者耐受性较好。 Objective To evaluate the efficacy and safety of bevacizumab combined with platinum-based chemotherapy as first-line therapy for patients with advanced non-squamous non-small-cell lung cancer（ NSCLC）.Methods Fifty-five advanced non-squamous NSCLC patients received bevacizumab（ 7. 5mg / kg every 3 weeks until disease progression） combined with pemetrexed plus cisplatin / carboplatin / nedaplatin（ pemetrexed group,n = 41） or docetaxel / paclitaxel / ABI-007 plus carboplatin（ taxane group,n = 14）. Efficacy was estimated by CT and MRI every two cycles and toxicity was documented. Results Among 55 patients,there was no case with complete response,33 cases with partial response,20 cases with stable disease and 2 cases with progressive disease. The overall response rate（ ORR） was60. 0%（ 33 /55）. The disease control rate（ DCR） was 96. 4%（ 53 /55）. The median PFS was higher in taxane group than in pemetrexed group,but the difference was not significant（ 8. 5 months vs 6. 5 months,P = 0. 058）. Taxane group received more maintenance treatment than pemetrexed group（ 4 cycles vs 9 cycles,P = 0. 000）. The ORR of patients receiving cisplatin-based therapy was higher than that of patients with carboplatin-based therapy（ 81. 0% vs 51. 6%,χ2= 4. 65,P =0. 031）. Four patients had to discontinue treatment： one with grade Ⅲ hypertension,one with subacute multiple cerebral infarction and two with massive hemoptysis. Most common adverse events were grade Ⅰ or Ⅱ. The adverse reactions were similar in patients treated with bevacizumab plus carboplatin and those receiving bevacizumab plus cisplatin. Conclusion The safety and efficacy of bevacizumab combined with platinum-based chemotherapy as first-line therapy for patients with non-squamous non-small-cell lung cancer is satisfactory

作者于韶荣史美祺夏国豪王丽冯继锋

机构地区江苏省肿瘤医院肿瘤内科

出处《实用肿瘤杂志》 CAS 2015年第5期418-422,共5页 Journal of Practical Oncology

基金国家自然科学基金(81402483) 江苏省基础研究计划(自然科学基金)青年基金项目(BK20141017)

关键词肺肿瘤/药物疗法抗体单克隆/治疗应用顺铂/治疗应用紫杉酚/治疗应用抗肿瘤联合化疗方案治疗结果回顾性研究 lung neoplasms/drug therapy antibodies, monoelonal/therapeutic use cisplatin/therapeutic use paclitaxel/therapeutic use antineoplastic combined chemotherapy protocols treatment outcome retrospective studies

分类号 R734.2 [医药卫生—肿瘤] R730.53 [医药卫生—肿瘤]

作者简介于韶荣（1982-），女，山东威海人，主治医师，博士，从事肿瘤诊治研究．通信作者E-mail：shimeiqil963@163．com

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