|本期目录/Table of Contents|

[1]张莉莉,许 峰,谢勋鹏,等.贝伐珠单抗辅助化疗非小细胞肺癌的临床应用[J].中华肺部疾病杂志,2025,(02):284-288.[doi:10.3877/cma.j.issn.1674-6902.2025.02.015]
　Zhang Lili,Xu Feng,Xie Xunpeng,et al.Clinical application of bevacizumab as adjuvant chemotherapy for non-small cell lung cancer[J].,2025,(02):284-288.[doi:10.3877/cma.j.issn.1674-6902.2025.02.015]
点击复制

贝伐珠单抗辅助化疗非小细胞肺癌的临床应用(PDF)

《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:
期数:
2025年02期
页码:
284-288
栏目:
论著
出版日期:
2025-04-25

文章信息/Info

Title:
Clinical application of bevacizumab as adjuvant chemotherapy for non-small cell lung cancer
作者:
张莉莉1; 许 峰2; 谢勋鹏1; 张学良3; 季红华4; 季雯绯1
226000 南通,南通市第三人民医院 南通大学附属南通第三医院肿瘤科1；226006 南通,南通市肿瘤医院胸外科2；226006 南通,南通市肿瘤医院胃肠外科3；226000 南通,南通市第三人民医院 南通大学附属南通第三医院呼吸科4
Author(s):
Zhang Lili1;  Xu Feng2;  Xie Xunpeng1;  Zhang Xueliang3;  Ji Honghua4;  Ji Wenfei1.
1Department of Oncology; 4Department of respiratory medicine, Nantong Third Hospital affiliated to Nantong University, Nantong 226000, China; 2Department of Thoracic Surgery; 3Stomach Enterochirurgia, Nantong Cancer Hospital, Nantong 226006, China
关键词:
贝伐珠单抗;  规范化疗;  非小细胞肺癌;  临床疗效
Keywords:
Bevacizumab;  Standardized chemotherapy;  Non-small cell lung cancer;  Clinical efficacy
分类号:
R734.2
DOI:
10.3877/cma.j.issn.1674-6902.2025.02.015
摘要:
目的 分析贝伐珠单抗注射液(安维汀)联合标准化化疗在老年非小细胞肺癌(non small-cell lung cancer, NSCLC)患者中的疗效及安全性。方法 将2017年1月至2022年12月我院收治的老年NSCLC患者74例,根据治疗方法不同分为,接受紫杉醇与顺铂联合化疗(TP)方案34例为对照组,采用TP联合贝伐珠单抗40例为观察组。疗程6个周期(18周)治疗。分析两组的临床疗效、肿瘤标志物水平及免疫功能、总体生存率(overall survival rate, OS)、无进展生存期(progression-free survival, PFS)以及治疗相关的不良事件(adverse events, AEs)。结果 观察组有效31例(77.50%)高于对照组有效20例(58.82%),两组比较无明显差异。观察组治疗后,癌胚抗原(carcinoembryonic antigen, CEA)(16.75±2.45)ng/ml、糖类抗原125(carbohydrate antigen 125, CA125)(35.97±4.46)ng/ml, 细胞角蛋白19片段(cytokeratin, CY211)(15.45±2.43)U/ml低于对照组CEA(20.93±3.16)ng/ml、CA125(50.11±6.58)ng/ml,CY211(20.35±3.26)U/ml; 观察组治疗后,免疫功能CD3+(49.16±4.32),CD4+(30.31±3.41),CD8+(32.56±4.30),自然杀伤细胞(natural killer cell, NK)(21.02±3.06)优于对照组(45.40±4.12),(26.68±3.02),(35.79±4.69),(17.69±2.21)(P<0.05)。观察组随访期间死亡11例,平均OS 20.34个月(18.70,21.96); 对照组随访期间死亡16例,平均OS 15.03个月(12.83,17.37),两组差异具有统计学意义(χ2=4.992,P=0.025)。观察组药物不良反应率20.00%,对照组23.53%,差异没有统计学意义(P>0.05)。 结论 贝伐珠单抗注射液(安维汀)联合标准化化疗可提高NSCLC患者的临床疗效,延长无进展生存期和总体生存期,未增加不良反应发生率,对老年NSCLC治疗中具有临床意义。
Abstract:
Objective To analyze the efficacy and safety of Bevacizumab injection(Avastin)combined with standardized chemotherapy in elderly patients with non-small cell lung cancer(NSCLC). Methods A total of 74 elderly NSCLC patients admitted to our hospital from January 2017 to December 2022 were enrolled, divided into two groups based on treatment methods: 34 patients received a combination of paclitaxel and cisplatin chemotherapy(TP)as the control group, and 40 patients received a combination of TP and bevacizumab as the observation group. The treatment course lasted six cycles(18 weeks). Clinical efficacy, tumor marker levels, immune function, overall survival rate(OS), progression-free survival(progression-free survival, PFS), and treatment-related adverse events(AE)were analyzed between the two groups. Results The total effective rate in the observation group was 31 cases(77.50%), while that in the control group was 20 cases(58.82%). The total effective rate of the observation group was higher than that of the control group there was no significant difference between two groups. After treatment, the carcinoembryonic antigen(carcinoembryonic antigen, CEA)level in the observation group decreased to 16.75±2.45)ng/ml, carbohydrate antigen 125(carbohydrate antigen 125, CA125)(35.97±4.46)ng/ml, cytokeratin 19 fragment(cytokeratin, CY211)(15.45±2.43)U/ml; lower than the control group CEA(20.93±3.16)ng/ml, CA125(50.11±6.58)ng/ml, CY211(20.35±3.26)U/ml; in the observation group after treatment, immune function CD3+(49.16±4.32), CD4+(30.31±3.41), CD8+(32.56±4.30), natural killer cells(NK)(21.02±3.06)were better than the control group(45.40±4.12),(26.68±3.02),(35.79±4.69),(17.69±2.21)(P<0.05). During the follow-up period of the observation group, 11 cases died, and an average OS of 20.34 months(18.70,21.96); 16 deaths in the control group, average OS 15.03 months(12.83,17.37), the difference between the two groups was statistically significant(χ2=4.992, P=0.025). The adverse drug reaction rate in the observation group was 20.00%, in the control group was 23.53%, with no statistical significance(P>0.05). Conclusion Bevacizumab injection(Avastin)combined with standardized chemotherapy can improve clinical efficacy in elderly NSCLC patients, extend progression-free survival and overall survival, without increasing the incidence of adverse reactions, demonstrating good clinical efficacy and safety in the treatment of elderly NSCLC.

参考文献/References:

1 Lee J, Kim JH, Kim CW. CyberKnife-based stereotactic radiosurgery or fractionated stereotactic radiotherapy in older patients with brain metastases from non-small cell lung cancer.[J]. ROJ, 2023, 41(4): 258-266.
2 王洪武, 金发光. 晚期非小细胞肺癌多域整合治疗策略[J/CD]. 中华肺部疾病杂志(电子版), 2022, 15(4): 457-461.
3 Ruchira M, Sajjad AB, Bradley CM, et al. Real-world survival of first-line immune checkpoint inhibitor treatment versus chemotherapy in older patients with non-small-cell lung cancer and synchronous brain metastases[J]. JCO Oncol Pract, 2023, 19(11): 1009-1019.
4 Nicholas JB, Patel JD, Wakelee HA, et al. Phase Ⅱ randomized trial of carboplatin, pemetrexed, and bevacizumab with and without atezolizumab in stage Ⅳ nonsquamous non-small-cell lung cancer patients who harbor a sensitizing EGFR mutation or have never smoked[J]. Clin Lung Cancer, 2023, 24(7): e242-e246.
5 Fan Z, Di H, Tao L, et al. Anti-PD-1 therapy plus chemotherapy and/or bevacizumab as second line or later treatment for patients with advanced non-small cell lung cancer.[J]. J Cancer, 2020, 11(3): 741-749.
6 陈国群, 蔡姣迪. 2022年美国国立综合癌症网络(NCCN)《非小细胞肺癌临床诊疗指南》(第4版及第5版)解读[J]. 诊断学理论与实践, 2023, 22(1): 8-13.
7 Mustachio LM, Roszik J. Current targeted therapies for the fight against non-small cell lung cancer[J]. Pharmaceuticals(Basel), 2020, 13(11): 374.
8 Liang HY, Liu Do, Wang H, et al. Pre-existing cardiometabolic comorbidities and survival of middle-aged and elderly non-small cell lung cancer patients[J]. J Geriatr Cardiol, 2023, 20(10): 737-747.
9 王 朝, 韩 雪, 张爱霞. LIPI评分对PD-1/PD-L1抑制剂治疗非小细胞肺癌效果与预后的价值分析[J]. 中国现代医学杂志, 2023, 33(6): 55-60.
10 吴冠锦, 刘 祎, 焦丽静, 等. 非小细胞肺癌表皮生长因子受体酪氨酸酶抑制药耐药通路抑制剂的临床应用现状[J]. 中国临床药理学杂志, 2023, 39(6): 893-897.
11 Ko R, Mouri A, Kisohara A, et al. 1292MO A phase Ⅱ study of daily carboplatin plus irradiation followed by durvalumab for unresectable Ⅲ non-small cell lung cancer patients with PS 2 or elderly(≧75 years): NEJ039A[J]. Ann Oncol, 2023, 34(S2): S745-S746.
12 贾琎蕊, 李晓红, 胡 滨. 老年非小细胞肺癌患者术后生活质量的纵向研究[J]. 中华老年多器官疾病杂志, 2024, 23(6): 416-420.
13 Zeeshan T, McKenna B. A durable response to osimertinib in an elderly patient with EGFR T790M positive metastatic non-small-cell lung cancer after progression on erlotinib[J]. Am J Ther, 2023, 30(5): e463-e465.
14 张亚玲, 刘 单, 邓述恺. 贝伐珠单抗通过调控PI3K/AKT信号通路下调肺腺癌H1299细胞PD-L1表达[J]. 中国免疫学杂志, 2023, 39(1): 104-108.
15 孙晋瑞, 何 玥, 吴玉梅. 贝伐珠单抗在晚期及复发性卵巢癌治疗中的研究进展[J]. 实用妇产科杂志, 2024, 40(6): 464-468.
16 Marrone KA, Zhou X, Forde PM, et al. A randomized phase Ⅱ study of metformin plus paclitaxel/carboplatin/bevacizumab in patients with chemotherapy-naïve advanced or metastatic nonsquamous non-small cell lung cancer[J]. Oncologist, 2018, 23(7): 859-865.
17 Zhang F, Huang D, Li T, et al. Anti-PD-1 therapy plus chemotherapy and/or bevacizumab as second line or later treatment for patients with advanced non-small cell lung cancer[J]. J Cancer, 2020, 11(3): 741-749.
18 侯俊杰, 米旭光, 李孝男, 等. 贝伐珠单抗联合紫杉醇治疗非小细胞肺癌过程中并发支气管胸膜瘘1例报告及文献复习[J]. 吉林大学学报(医学版), 2022, 48(2): 513-517.
19 陈海韬, 杨森森, 邓为上, 等. 贝伐珠单抗生物类似药和原研药治疗非小细胞肺癌有效性、安全性和免疫原性的Meta分析[J]. 中国药房, 2022, 33(8): 1003-1008.
20 王 晨, 李 艳, 管 燕, 等. EGFR-TKIs治疗失败非小细胞肺癌患者采用免疫联合化疗及贝伐珠单抗治疗的疗效及影响因素[J]. 中华医学杂志, 2023, 103(16): 1210-1216.
21 Maciej L, Josiane O, PierreYves B, et al. Safety and efficacy of two-drug combination in elderly patients with locally advanced non-small cell lung cancer and validation of the Charlson Index as a predictor of survival.[J]. J Thorac Dis, 2023, 15(7): 3764-3775.
22 Toshio K, Eiki I, Daijiro H, et al. Efficacy of immune checkpoint inhibitor monotherapy in elderly patients with non-small-cell lung cancer[J]. Resp Investig, 2023, 61(5): 643-650.
23 杨光霞, 程云涛, 刘琳琳, 等. 阿美替尼片联合贝伐珠单抗注射液治疗表皮生长因子受体突变的晚期非小细胞肺癌患者的临床研究[J]. 中国临床药理学杂志, 2023, 39(11): 1528-1532.
24 顾艳斐, 田笑如, 王若天, 等. 奥希替尼联合贝伐珠单抗在获得性EGFRT790M突变晚期非小细胞肺癌的疗效分析[J]. 中国肺癌杂志, 2022, 25(12): 843-851.
25 Lipin L, Runze L, Yue P, et al. Surgery vs. radiotherapy in a population-based cohort of elderly patients with early-stage small-cell lung cancer: an IPTW propensity-score analysis[J]. J Thorac Dis, 2023, 15(5): 2769-2778.
26 Qin Y, Ma FY, Zhang Z, et al. Vascular endothelial growth factor pathway's influence on bevacizumab efficacy in metastatic colorectal cancer treatment[J]. World J Gastrointest Oncol, 2024, 16(11): 4514-4517.
27 Gao Y, Liu Z, Liu Y. Cisplatin combined with capecitabine-induced chemotherapy for local nasopharyngeal carcinoma can improve the quality of life and reduce toxic and side effects[J]. World J Surg Oncol, 2021, 19(1): 280.
28 Zhang S, Mi Y, Ye T, et al. Carbohydrates and ginsenosides in shenmai injection jointly improve hematopoietic function during chemotherapy-induced myelosuppression in mice[J]. Chin Med, 2022, 17(1): 124.
29 Fang S, Cao H, Liu J, et al. Antitumor effects of IOX1 combined with bevacizumab-induced apoptosis and immunity on colorectal cancer cells[J]. Int Immunopharmacol, 2024, 141: 112896.
30 张佳慧, 郭其森, 张初峰, 等. EGFR 20外显子插入突变晚期NSCLC化疗联合免疫治疗对比联合贝伐珠单抗临床分析[J]. 中华肿瘤防治杂志, 2022, 29(11): 828-833.

备注/Memo

备注/Memo:
基金项目: 江苏省基础研究计划自然科学基金(BK20230151)
通信作者: 张学良, Email: zhangxueliang2000@126.com
更新日期/Last Update: 2025-04-25