小分子酪氨酸激酶抑制剂联合程序性死亡受体-1单抗治疗晚期消化系统恶性肿瘤的疗效评价

Analysis of small molecule tyrosine kinase inhibitor combined with monoclonal antibody of programmed death receptor-1 in treatment of patients with advanced malignant tumors of digestive system

  • 摘要:
      目的  分析小分子酪氨酸激酶抑制剂(TKI)联合程序性死亡受体-1(PD-1)单抗治疗晚期消化系统恶性肿瘤的疗效及安全性。
      方法  回顾性分析中国医科大学附属第一医院肿瘤内科2019年3月—2021年2月应用小分子TKI联合PD-1单抗治疗的晚期消化系统恶性肿瘤患者用药后的疗效、不良反应、肿瘤生长速率以及不良反应与疗效的相关性。
      结果  共纳入30例患者,25例可评价疗效,其中胃肠癌客观缓解率(ORR)、疾病控制率(DCR)分别为0、58.33%,肝癌ORR、DCR分别为50.00%、100.00%,胰腺癌ORR、DCR分别为33.30%、100.00%,食管癌ORR、DCR分别为50.00%、100.00%。肿瘤生长速率、免疫相关不良反应发生情况与DCR存在相关性,差异有统计学意义(P < 0.05)。
      结论  TKI联合PD-1单抗在晚期消化系统恶性肿瘤的治疗中表现出一定的抗肿瘤活性,并且肝癌患者联合治疗的获益更多。联合治疗过程中,肿瘤生长速率慢的患者疗效较好。

     

    Abstract:
      Objective  To analyze the efficacy and safety of small molecule tyrosine kinase inhibitor (TKI) combined with monoclonal antibody of programmed death receptor-1 (PD-1) in the treatment of patients with advanced malignant tumors of digestive system.
      Methods  The efficacy and adverse reactions, tumor growth rate and correlation between adverse reactions and efficacy in the patients with advanced malignant tumors of digestive system by combined treatment of TKI and monoclonal antibody of PD-1 from March 2019 to February 2021 in the Internal Department of Oncology of the First Hospital of China Medical University were analyzed retrospectively.
      Results  Among the 30 included patients, 25 patients were available for efficiency evaluation. The objective response rate (ORR) and disease control rate (DCR) of cases with gastric and intestinal cancers were 0 and 58.33% respectively, the ORR and DCR of cases with liver cancer were 50.00% and 100.00% respectively, the ORR and DCR of cases with pancreatic cancer were 33.30% and 100.00% respectively, and the ORR and DCR of cases with esophageal cancer were 50.00% and 100.00% respectively. There were significant correlations between tumor growth rate, immune related adverse events and DCR (P < 0.05).
      Conclusion  TKI combined with monoclonal antibody of PD-1 shows a certain anti-tumor activity in the treatment of patients with advanced malignant tumors of digestive system, and the patients with liver cancer are prone to have more benefits from combined treatment. In the course of combined therapy, patients with slow tumor growth rate have better curative effect.

     

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