Zhongguo aizheng zazhi (May 2024)
Effect of bevacizumab assisted PD-1 inhibitor on serum miR-20a-5p and miR-515-3p in the treatment of gastric cancer
Abstract
Background and purpose: Second-line chemotherapy is not effective in the treatment of gastric cancer. Bevacizumab is a molecularly targeted anticancer drug, and sindilizumab is a domestic programmed death-1 (PD-1) inhibitor. The combination of the two is a new direction for clinical treatment of gastric cancer. This study aimed to analyze the effects of bevacizumab assisted PD-1 inhibitor in the treatment of gastric cancer on serum miR-20a-5p and miR-515-3p. Methods: A retrospective study was conducted on 84 patients with gastric cancer treated in the Fourth Affiliated Hospital of Nanjing Medical University from January 2019 to July 2021, and they were divided into the observation group and the control group with 42 cases each according to different treatment plans. The control group was given second-line chemotherapy, and the observation group was given bevacizumab combined with PD-1 inhibitor (sindilizumab) on the basis of the control group. objective response rate (ORR), disease control rate (DCR), serum tumor markers, immune function indexes, serum miR-20a-5p and miR-515-3p levels and total incidence of toxic and side effects were compared between the two groups. This study has been approved by the Ethics Committee of the Fourth Affiliated Hospital of Nanjing Medical University (approval number: 20230531--K061). Results: The ORR (69.05%) and DCR (85.71%) of the observation group were higher than those of the control group (40.48% and 64.29%), and the difference was statistically significant (P<0.05). After treatment, serum carbohydrate antigen 12-5 (CA12-5), carcinoembryonic antigen (CEA) and cytokerantin-19-fragment antigen 21-1 (CYFRA21-1) levels were lower in observation group than in control group (P<0.05). CD4+ T lymphocyte and CD4+/CD8+ T lymphocyte ratio were higher in observation group than in control group after treatment (P<0.05), and CD8+ T lymphocyte was lower in observation group than in control group after treatment (P<0.05). After treatment, the serum levels of miR-20a-5p and miR-515-3p were lower in the observation group than in the control group (P<0.05). There was no significant difference in total incidence of adverse effects between the observation group (28.57%) and the control group (38.10%) (P>0.05). Conclusion: Bevacizumab assisted sindilizumab can effectively improve the treatment efficiency of gastric cancer, improve immune function, and reduce the expression levels of serum miR-20a-5p, miR-515-3p and tumor markers, without increasing toxic and side effects.
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