Guoji laonian yixue zazhi (Mar 2024)
Clinical of PD-1 Inhibitor Combined with Arotinib in the Treatment of Elderly Patientswith Advanced Non-small Cell Lung Cancer Who Failed to UndergoSecond-line Chemotherapy
Abstract
Objective To explore the clinical efficacy of a programmed death receptor 1(PD-1) inhibitor in combination with amilorotinib in the treatment of elderly advanced non-small cell lung cancer(NSCLC) that has failed second-line chemotherapy. Methods A total of 106 elderly advanced NSCLC patients who failed second-line chemotherapy admitted to Taizhou Second People's Hospital from January 2019 to April 2021 were selected as the study subjects, they were divided into the single-agent group and the combination group according to the method of randomized numerical table, each had 53 cases.The single-agent group was treated with Anlotinib, and the combination group was treated with PD-1 inhibitor combined with Anlotinib.The indicators of disease control rate, incidence of toxic side reactions, survival rate, tumor markers [cytokeratin 19 fragment antigen 21-1(CYFRA21-1), carcinoembryonic antigen(CEA), carbohydrate antigen 125(CA125)] , angiogenesis indicators [vascular endothelial growth factor(VEGF-A), VEGF receptor 2(VEGFR2)] , serum kinesin superfamily protein(KIF) C1, N-cadherin and the Quality of Life Core Scale(QLQ-C30) scores were compared. Results The disease control rate in the combination group was higher than that in the monotherapy group(P0.05);Kaplan Meier survival analysis showed that the combined group had a higher cumulative survival rate than the monotherapy group(P<0.05). Conclusion The PD-1 inhibitor combined with Anlotinib is effective in the treatment of second-line chemotherapy failure of elderly advanced NSCLC.It can effectively regulate serum KIFC1, N-calcium fucoidan expression, inhibit the level of VEGF-A, VEGFR2, reduce the level of tumor markers, improve the quality of life, prolong the survival time, and high safety.
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