吉西他滨/纳米-紫杉醇联合安洛替尼和PD-1抑制剂作为晚期胰腺癌一线治疗的疗效与安全性

Efficacy and safety of gemcitabine/nab-paclitaxel combined with anlotinib and PD-1 inhibitors as a first-line treatment for advanced pancreatic cancer

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INTERNATIONAL IMMUNOPHARMACOLOGY

影响因子:4.7

分区:医学2区 / 药学2区免疫学3区

发表日期:2024 Sep 30

作者: Haonan Liu, Di Pan, Zhiyuan Yao, Hongmei Wang, Yuqi Li, Xiaobing Qin, Pengfei Qu, Juanjuan Tang, Zhengxiang Han

DOI: 10.1016/j.intimp.2024.112635

摘要

为探究吉西他滨/纳米紫杉醇（AG方案）联合安洛替尼和PD-1抑制剂作为晚期胰腺癌（PC）一线治疗的临床疗效及不良反应，回顾性分析了2019年8月至2023年3月在徐州医科大学附属医院接受治疗的52例晚期PC患者的资料。根据治疗方案，患者分为两组，包括27例化疗组（AG方案）和25例联合治疗组（AG方案联合安洛替尼和PD-1抑制剂）。比较两组的总体生存期（OS）、无进展生存期（PFS）、客观反应率（ORR）、疾病控制率（DCR）及不良反应，采用Kaplan-Meier方法绘制生存曲线，并用Log-rank检验比较PFS和OS的差异。采用单因素和多因素Cox回归分析，识别影响预后的独立风险因素。结果显示，联合治疗组的中位OS（12.8个月）和中位PFS（5.6个月）均显著优于化疗组（分别为7.9和4.4个月，P=0.005和0.003）。两组间的ORR差异无统计学意义（32.0% vs. 25.9%，P=0.629），但DCR在联合组中显著优于化疗组（84.0% vs. 59.3%，P=0.049）。两组中以1-2级不良反应为主，未发生不良反应相关的死亡。总体而言，与单纯化疗相比，AG方案联合安洛替尼和PD-1抑制剂在晚期PC一线治疗中显示出更高的疗效，不良反应可控。

Abstract

To investigate the clinical efficacy and adverse reactions of gemcitabine/nab-paclitaxel (AG regimen) combined with anlotinib and PD-1 inhibitors as a first-line treatment for advanced pancreatic cancer (PC).Data of 52 patients with advanced PC who were treated in the Affiliated Hospital of Xuzhou Medical University (Xuzhou, China) between August 2019 and March 2023 were retrospectively analyzed. According to the treatment regimen, patients were divided into two groups, including 27 patients in the chemotherapy group (AG regimen) and 25 patients in the combined treatment group (AG regimen combined with anlotinib and PD-1 inhibitors). Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and adverse reactions were compared between the two groups. The survival curves of the two groups were drawn using the Kaplan-Meier method, and the differences in PFS and OS between the two groups were compared by the log-rank test. Univariate and multivariate Cox regression analyses were performed to identify independent risk factors influencing prognosis.The median OS and PFS in the combined treatment group were significantly longer than those in the chemotherapy group (OS, 12.8 vs. 7.9 months, P = 0.005; PFS, 5.6 vs. 4.4 months, P = 0.003). There was no significant difference in ORR between the two groups (32.0 % vs. 25.9 %, P = 0.629), and DCR in the combined treatment group was significantly better than that in the chemotherapy group (84.0 % vs. 59.3 %, P = 0.049). Grade 1-2 adverse reactions were predominant in both groups, and no adverse reaction-related deaths occurred.Compared with chemotherapy alone, AG regimen combined with anlotinib and PD-1 inhibitors exhibited to have a higher efficacy for the first-line treatment of advanced PC, and the adverse reactions were also controllable.