化疗联合卡瑞利珠单抗用于不可手术微卫星稳定型结直肠癌的临床观察
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篇名: 化疗联合卡瑞利珠单抗用于不可手术微卫星稳定型结直肠癌的临床观察
TITLE: Clinical observation of chemotherapy combined with camrelizumab in patients with inoperable microsatellite stable type colorectal cancer
摘要: 目的 评价XELOX(奥沙利铂+卡培他滨)化疗联合抗血管生成剂(阿帕替尼)和免疫治疗药物(卡瑞利珠单抗)用于不可手术转移性微卫星稳定(MSS)型结直肠癌(CRC)的疗效与安全性。方法回顾性收集2020年1月-2021年1月丽水市人民医院收治的40例不可手术转移性MSS型CRC患者的临床资料。根据治疗方案将患者分为对照组(20例)和观察组(20例)。对照组患者接受XELOX+阿帕替尼治疗,观察组患者接受XELOX+阿帕替尼+卡瑞利珠单抗治疗。每3周为1个周期,连续治疗2个周期。记录两组患者的客观缓解率(ORR)、疾病控制率(DCR)、无进展生存期(PFS)、总生存期(OS)和不良事件(AEs)发生情况。结果观察组患者的ORR和DCR分别为65.0%、85.0%,对照组患者的ORR和DCR分别为35.0%、75.0%,组间比较差异均无统计学意义(P>0.05)。观察组和对照组患者的中位PFS分别为16.0、8.0个月,中位OS分别为19.0、12.5个月,组间比较差异均有统计学意义(P<0.05)。两组患者均至少发生1次AEs,且观察组患者的反应性皮肤毛细血管增生、甲亢的发生率均显著高于对照组(40.0%vs.0和20%vs.0,P<0.05),恶心和呕吐的发生率显著低于对照组(10%vs.90%,P<0.05)。观察组患者发生3级及以上AEs的有14例(70.0%),而对照组仅有5例(25.0%),组间比较差异有统计学意义(P<0.05)。但两组患者均未发生不能耐受或致命的严重AEs,相关症状经停药或接受治疗后均得以缓解。结论XELOX化疗联合阿帕替尼和卡瑞利珠单抗用于不可手术转移性MSS型CRC患者的效果与XELOX化疗联合阿帕替尼相当,但具有一定的ORR、PFS和OS优势,且安全性可控。
ABSTRACT: OBJECTIVE To evaluate the clinical efficacy and safety of XELOX chemotherapy (oxaliplatin+capecitabine) combined with antiangiogenic agent (apatinib) and immunotherapy (camrelizumab) in patients with inoperable metastatic colorectal cancer (CRC)of microsatellite stable (MSS) type. METHODS Clinical medical records of 40 patients with inoperable metastatic CRC of MSS type treated in Lishui People’s Hospital from January 2020 to January 2021 were retrospectively collected. According to the treatment plan, the patients were divided into control group (20 cases) and observation group (20 cases). Control group was given XELOX+apatinib regimen, while observation group was given XELOX+apatinib+camrelizumab regimen. Every 3 weeks was a treatment cycle, and the treatment lasted for 2 consecutive cycles. The objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS) and adverse events (AEs) were recorded for all patients. RESULTS The ORR and DCR of observation group were 65.0% and 85.0%, respectively; and the ORR and DCR of control group were 35.0% and 75.0%, respectively, with no statistical significance between 2 groups (P>0.05). The median PFS of observation group and control groups were 16.0 months and 8.0 months, respectively; and the median OS were 19.0 months and 12.5 months, respectively, with statistical significance between 2 groups (P<0.05). Each patient in both groups had at least one AEs, and the incidences of reactive skin capillary hyperplasia and hyperthyroidism in observation group (40.0%, 20.0%) were significantly higher than those in control group (both were 0) (P<0.05). The incidence of nausea and vomiting in control group (90%) was significantly higher than observation group (10%) (P<0.05). There were 14 cases (70.0%) of patients with grade 3 or above AEs in observation group, and only 5 cases (25.0%) in control group, with statistical significance between 2 groups (P<0.05). However, no severe AEs that could not be tolerated or fatal occurred in the two groups, which could be alleviated after drug withdrawal or treatment. CONCLUSIONS The efficacy of XELOX chemotherapy combined with apatinib and camrelizumab in inoperable metastatic CRC patients of MSS type is comparable to that of XELOX chemotherapy combined with apatinib, but it has certain advantages in ORR, PFS and OS, and controllable safety.
期刊: 2023年第34卷第10期
作者: 虞伟妃;汪笑秋;赵丽萍;冯继红;周珏伊
AUTHORS: YU Weifei,WANG Xiaoqiu,ZHAO Liping,FENG Jihong,ZHOU Jueyi
关键字: 不可手术;微卫星稳定型;转移性结直肠癌;化疗;免疫治疗;抗血管生成剂
KEYWORDS: inoperable; microsatellite stable type; meta-
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