2023 年第 10 期 第 18 卷

培美曲塞加顺铂联合贝伐珠单抗一线治疗表皮生长因子受体驱动基因野生型肺腺癌的临床效果观察

Observation of clinical effect of pemetrexed and cisplatin combined with bevacizumab on first-line treatment of wild-type lung adenocarcinoma with epidermal growth factor receptor driven gene

作者：朱峰1高蕙敏1周赟云2王晓芸1

英文作者：Zhu Feng1 Gao Huimin1 Zhou Yunyun2 Wang Xiaoyun1

单位：1上海交通大学医学院附属新华医院药剂管理科，上海200092；2再鼎医药(上海)有限公司临床运营部，上海201210

英文单位：1Department of Pharmaceutical Administration Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai 200092 China; 2Department of Clinical Operation Zaiding Pharmaceutical (Shanghai) Co. Ltd. Shanghai 201210 China

关键词：肺腺癌；培美曲塞；顺铂；贝伐珠单抗；表皮生长因子受体

英文关键词：Lungadenocarcinoma;Pemetrexed;Cisplatin;Bevacizumab;Epidermalgrowthfactorreceptor

• 摘要：

• 目的  探讨培美曲塞加顺铂联合贝伐珠单抗一线治疗表皮生长因子受体（EGFR）驱动基因野生型肺腺癌的临床效果。方法  收集2020年1月至2022年1月上海交通大学医学院附属新华医院收治的85例EGFR驱动基因野生型肺腺癌患者的临床资料行回顾性分析，根据治疗方案的不同分为对照组（35例）和观察组（50例）。对照组给予培美曲塞+顺铂治疗，观察组给予培美曲塞+顺铂+贝伐珠单抗治疗。观察记录2组患者治疗效果、肿瘤标志物水平、药物毒性反应、预后状况，并进行统计学分析。结果  观察组有效率及疾病控制率均高于对照组［82.0%（41/50）比62.9%（22/35）、94.0%（47/50）比68.6%（24/35）］，差异均有统计学意义（均P<0.05）。治疗后2组血清癌胚抗原、糖类抗原125及细胞角质蛋白19片段抗原21-1水平均低于治疗前，且观察组低于对照组，差异均有统计学意义（均P<0.05）。2组患者治疗后各项药物毒性反应发生率比较差异均无统计学意义（均P>0.05）。Kaplan-Meier生存曲线分析结果显示，观察组无进展生存率、总生存率均高于对照组，差异均有统计学意义（Log-rank χ2=7.521、9.381，均P=0.001）。结论  培美曲塞加顺铂联合贝伐珠单抗一线治疗EGFR驱动基因野生型肺腺癌临床效果肯定，耐受性好，有助于延长患者生存时间。

• Objective  To explore the clinical effect of pemetrexed and cisplatin combined with bevacizumab on first-line treatment of wild-type lung adenocarcinoma with epidermal growth factor receptor(EGFR) driven gene. Methods  From January 2020 to January 2022, clinical data of 85 patients with wild-type lung adenocarcinoma with EGFR driven gene admitted to Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were collected for retrospectively analyzed, and they were divided into control group(35 cases) and observation group(50 cases) according to different treatment plans. The control group was treated with pemetrexed and cisplatin, and the observation group was treated with pemetrexed, cisplatin and bevacizumab. The treatment effect，tumor marker levels，drug toxicity reactions and prognosis in the two groups were observed and recorded, and statistical analysis was conducted. Results  The effective rate and disease control rate in the observation group were higher than those in the control group［82.0%(41/50) vs 62.9%(22/35), 94.0%(47/50) vs 68.6%(24/35)］ (both P<0.05). After treatment, the levels of serum carcinoembryonic antigen, carbohydrate antigen 125 and cytokeratin 19 fragment antigen 21-1 in the two groups were lower than those before treatment, and the observation group was lower than the control group (all P<0.05). There was no significant difference in the incidence of various drug toxicity reactions in the two groups after treatment(all P>0.05). The Kaplan-Meier survival curve analysis showed that the progression-free survival rate and total survival rate in the observation group were higher than those in the control group(Log-rank χ2=7.521, 9.381, both P=0.001）. Conclusion  The combination of pemetrexed, cisplatin and bevacizumab in the first-line treatment of wild-type lung adenocarcinoma with EGFR driven gene has positive clinical effect and good tolerance, which is helpful to prolong the survival time of patients.