摘要
目的 评估程序性死亡蛋白1(PD-1)单克隆抗体联合安罗替尼及化疗作为晚期胰腺癌一线治疗的临床疗效和安全性分析。方法 回顾性收集2021年5月至2023年5月徐州医科大学附属医院收治的PD-1单克隆抗体联合安罗替尼及化疗一线治疗晚期胰腺癌病人41例作为观察组,分析病人的近期、远期疗效及不良反应,利用Cox比例风险模型进行亚组分析,寻找免疫联合靶向及化疗治疗的优势人群。利用倾向评分配比法筛选同期一线接受单纯化疗的晚期胰腺癌病人41例作为对照组,比较两组在近期及远期疗效方面的差异。结果 观察组疾病控制率(82.9%比56.1%)高于对照组,差异有统计学意义(P<0.05)。观察组中位无进展生存期(6.8个月比5.1个月,P=0.005)及中位总生存期(13.0个月比8.4个月,P=0.009)均优于对照组。亚组分析显示,东部肿瘤协作组体能状态评分为0~1分及单发转移病人更能从免疫联合靶向治疗中获益。安全性方面,观察组常见的不良反应为大多为1~2级,3~4级不良反应主要是血液学毒性和肝功能异常。无致死性不良事件。结论 PD-1单克隆抗体联合安罗替尼及化疗一线治疗晚期胰腺癌病人具有良好的疗效和安全性。
Objective To evaluate the clinical efficacy and safety of a programmed death protein 1(PD-1)monoclonal antibody,in combination with anlotinib and chemotherapy,as first-line treatment for advanced pancreatic cancer.Methods In this retrospective study,41 cases patients with advanced pancreatic cancer receiving PD-1 monoclonal antibody in combination with anlotinib and chemotherapy as the first-line treatment in the Affiliated Hospital of Xuzhou Medical University from May 2021 to May 2023 served as the observation group.Analysis of short-term and long-term efficacy and adverse reactions(AEs)were conducted for these patients.Subgroup analysis using COX proportional risk model was done to select patients who could benefit most from PD-1 monoclonal antibody combined with anlotinib and chemotherapy.Chemotherapy-treated patients during the corresponding period were selected as the controlled group by propensity score matching method.A comparison was conducted regarding the short-term and long-term efficacy between the two groups.Results The disease control rate(82.9%vs.56.1%)in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).Median progression-free survival(6.8 months vs.5.1 months,P=0.005)and median overall survival(13.0 months vs.8.4 months,P=0.009)in the observation group were significantly better than those in the control group.In subgroup analysis,patients with an Eastern Cooperative Oncology Group Performance Status(ECOG PS)score of 0-1 or single metastasis lesion could benefit most from PD-1 monoclonal antibody combined with anlotinib and chemotherapy.In terms of safety,the common AEs in the observation group were mostly grade 1-2,In contrast,grade 3-4 AEs predominantly manifested as hematologic AEs and abnormal liver function.There were no fatal adverse events.Conclusion PD-1 monoclonal antibody combined with anlotinib and first-line chemotherapy has good efficacy and safety in patients with advanced pancreatic adenocarcinoma.
作者
纪雅玲
韩尚
王浩
陶云霞
汪海岩
JI Yaling;HAN Shang;WANG Hao;TAO Yunxia;WANG Haiyan(Department of Oncology,the Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221000,China)
出处
《安徽医药》
2026年第2期404-409,共6页
Anhui Medical and Pharmaceutical Journal
基金
徐州医科大学附属医院院级科研项目(2022ZL10)。
关键词
胰腺肿瘤
程序性死亡蛋白1
单克隆抗体
安罗替尼
一线治疗
Pancreatic neoplasms
Programmed cell death protein 1
Monoclonal antibody
Allotinib
First-line therapy
