施慧婕,孙子娟,司悦,等.安罗替尼联合程序性死亡受体 -1抑制剂及替吉奥后线治疗微卫星稳定型转移性结直肠癌的疗效及安全性[J].安徽医药,2024,28(11):2296-2300. |
安罗替尼联合程序性死亡受体 -1抑制剂及替吉奥后线治疗微卫星稳定型转移性结直肠癌的疗效及安全性 |
Efficacy and safety of anlotinib combined with PD-1 inhibitor and S-1 in the treatment of MSS type metastatic colorectal cancer |
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DOI:10.3969/j.issn.1009-6469.2024.11.040 |
中文关键词: 结直肠肿瘤 微卫星稳定型 肿瘤转移 安罗替尼 程序性死亡受体 -1抑制剂 替吉奥 |
英文关键词: Colorectal neoplasms Microsatellite stable Neoplasm metastasis Anlotinib PD-1 inhibitor S-1 |
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中文摘要: |
目的探讨安罗替尼联合程序性死亡受体 -1(PD-1)抑制剂及替吉奥的后线治疗在微卫星稳定( MSS)型转移性结直肠癌( mCRC)病人中的疗效及安全性。方法选取 2020年 1月至 2022年 1月徐州医科大学附属医院收治的既往经二线及以上标准治疗失败的转移性结直肠癌病人 43例,均给予安罗替尼联合 PD-1抑制剂及替吉奥治疗,评价疗效及不良反应,采用 Kaplan-Meier法并行 log-rank检验及 Cox比例风险模型进行生存分析。结果 43例病人中 5例死亡, 0例完全缓解, 10例部分缓解, 19例病情稳定, 9例疾病进展。客观有效率为 23.3%,疾病控制率为 67.4%,所有病人的中位无进展生存期( PFS)为 5.9个月,中位总生存期为 15.4个月。单因素分析显示无肝转移、原发灶部位位于左侧的病人 PFS较伴有肝转移、原发灶部位位于右侧的病人 PFS长,差异有统计学意义( P<0.05)。 Cox比例风险模型分析显示伴有肝转移是影响 mCRC病人 PFS的独立危险因素[HR=2.40,95%CI:(1.08,5.30),P=0.031]。其中最常见的不良反应有高血压、乏力、恶心呕吐、手足综合征等,所有 3级以上的不良反应都通过对症治疗和延迟给药得到控制。结论安罗替尼联合 PD-1抑制剂、替吉奥后线治疗 MSS型转移性结直肠癌有良好疗效,且毒副反应可控,为转移性结直肠癌后线的治疗提供了新见解。 |
英文摘要: |
Objective To investigate the efficacy and safety of post-treatment with anlotinib combined with programmed death receptor-1 (PD-1) inhibitor and S-1 in patients with microsatellite stable (MSS) metastatic colorectal cancer (mCRC).Methods Forty-three patients with metastatic colorectal cancer who had previously failed second line or above standard treatment in the Affiliated Hospitalof Xuzhou Medical University from January 2020 to January 2022 were randomly selected, all of whom were treated with anlotinib combined with PD-1 inhibitor and S-1. The efficacy and adverse reactions were evaluated, and survival analysis was conducted using Kaplan Meier method, Log rank test, and Cox proportional risk model.Results Among 43 patients, 5 died, 0 had complete remission , 10had partial remission,19 had stable disease, and 9 had disease progression. The objective response rate was 23.3%, the disease controlrate was 67.4%, the median progression free survival of all patients was 5.9 months, and the median total survival was 15.4 months. Univariate analysis showed that patients with no liver metastasis and primary lesion on the left had a longer progression free survival (PFS)compared to patients with liver metastasis and primary lesion on the right, with a statistically significant difference (P<0.05). Cox proportional risk model analysis showed that accompanied liver metastasis was an independent risk factor affecting PFS in mCRC patients[HR=2.40, 95% CI:(1.08,5.30), P=0.031]. The most common adverse reactions were hypertension, fatigue, nausea and vomiting, handfoot syndrome, etc. All Grade 3 or higher adverse reactions were controlled by symptomatic treatment and delayed dosing.Conclusion Anlotinib combined with PD-1 inhibitor and S-1 has good efficacy in the treatment of metastatic colorectal cancer of MSS type, and thetoxicity and side effects are controllable, which provides new insights into the treatment of metastatic colorectal cancer in the backline. |
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