新辅助免疫联合化疗在非小细胞肺癌中的初步疗效观察

doi:10.3969/j.issn.1006-7795.2024.04.013

首都医科大学学报 ›› 2024, Vol. 45 ›› Issue (4): 642-648.doi: 10.3969/j.issn.1006-7795.2024.04.013

• 肺癌新辅助免疫治疗临床研究 • 上一篇下一篇

新辅助免疫联合化疗在非小细胞肺癌中的初步疗效观察

吴朝真, 郑华, 盛舒言, 张权, 张卉, 李杰, 吕嘉林, 钱哲, 王守正, 李曦^*#, 胡瑛^*#

首都医科大学附属北京胸科医院/北京市结核病胸部肿瘤研究所肿瘤内二科，北京 101149

收稿日期:2024-04-22 出版日期:2024-08-21 发布日期:2024-07-08
通讯作者: 李曦, 胡瑛 E-mail:lixibj@126.com, huying@bjxkyy.cn
基金资助:
北京市卫健委重大项目（Feiai 2024-2）。

Observation on the preliminary efficacy of neoadjuvant immunotherapy combined with chemotherapy in non-small cell lung cancer

Wu Zhaozhen， Zheng Hua, Sheng Shuyan, Zhang Quan, Zhang Hui, Li Jie, Lyu Jialin, Qian Zhe, Wang Shouzheng, Li Xi ^*#, Hu Ying^*#

The Second Department of Oncology, Beijing Chest Hospital, Capital Medical University; Beijing Tuberculosis and Thoracic Tumor Research Institute, the Second Oncology Department, Beijing 101149, China

Received:2024-04-22 Online:2024-08-21 Published:2024-07-08
Supported by:
This study was supported by Major Projects of Beijing Health Commission（Feiai 2024-2）.

摘要/Abstract

摘要： 目的观察新辅助程序性死亡受体1（programmed receptor 1, PD-1）单抗免疫治疗联合化学药物治疗（以下简称化疗）在非小细胞肺癌（non-small cell lung cancer，NSCLC）中的近期疗效。方法纳入接受新辅助免疫联合化疗的IB~Ⅲ期NSCLC患者176例，之后159例（90.34%）患者接受手术治疗，包括腺癌42例、鳞癌115例和混合癌2例。结果所有患者接受新辅助治疗的中位周期数为2个周期，4例（2.5%）患者术前达到完全缓解（complete response, CR），115例（72.3%）患者达到部分缓解（partial response, PR），40例（25.2%）患者评估为疾病稳定（stable disease, SD）且仅有2例病灶增大；术后96例（60.4%，95%CI： 52.7%～68.1%）患者达到显著病理缓解（major pathological response, MPR）, 74例（46.5%，95%CI：38.7%～54.4%）患者达到病理完全缓解（pathological complete response, pCR）; 多因素分析显示，性别和程序性死亡配体1（programmed ligand 1, PD-L1）显著影响MPR率和pCR率。结论新辅助免疫联合化疗在IB~Ⅲ期NSCLC治疗中初现疗效，PD-L1的表达水平可能是MPR和pCR的预测因素。

关键词: 新辅助化疗, PD-1单抗, 非小细胞肺癌, 疗效

Abstract: Objective To evaluate the efficacy of neoadjuvant programmed receptor 1 (PD-1) monoclonal antibody immunotherapy combined with chemotherapy for non-small cell lung cancer（NSCLC）. Methods This study included 176 patients with stage ⅠB~Ⅲ resectable NSCLC who received neoadjuvant immunotherapy combined with chemotherapy at our research center from January 2021 to December 2023. Totally, 159 patients (90.34%) received surgical treatment, including 42 cases of adenocarcinoma and 115 cases of squamous cell carcinoma. Results The median number of neoadjuvant treatment cycles was 2, with 4 patients (2.5%) achieving complete response (CR), 115 patients (72.3%) achieving partial response (PR), and 40 patients (25.2%) assessed as stable disease (SD) with only 2 cases of tumor enlargement; After surgery, 96 patients (60.4%, 95% CI: 52.7%-68.1%) achieved major pathological response (MPR), and 74 patients (46.5%, 95% CI: 38.7%-54.4%) achieved pathological complete response (pCR); Multivariate analysis showed that gender and programmed ligand 1 (PD-L1) significantly influenced the rates of MPR and pCR. Conclusion Neoadjuvant immunotherapy combined with chemotherapy showed initial efficacy in resectable stage ⅠB~Ⅲ NSCLC, and the expression level of PD-L1 may be a predictive factor for MPR and pCR.

Key words: neoadjuvant chemotherapy, PD-1 monoclonal antibody, , non-small cell lung cancer（NSCLC）, efficacy

中图分类号:

R734.2

吴朝真, 郑华, 盛舒言, 张权, 张卉, 李杰, 吕嘉林, 钱哲, 王守正, 李曦, 胡瑛. 新辅助免疫联合化疗在非小细胞肺癌中的初步疗效观察[J]. 首都医科大学学报, 2024, 45(4): 642-648.

Wu Zhaozhen, Zheng Hua, Sheng Shuyan, Zhang Quan, Zhang Hui, Li Jie, Lyu Jialin, Qian Zhe, Wang Shouzheng, Li Xi , Hu Ying. Observation on the preliminary efficacy of neoadjuvant immunotherapy combined with chemotherapy in non-small cell lung cancer[J]. Journal of Capital Medical University, 2024, 45(4): 642-648.

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新辅助免疫联合化疗在非小细胞肺癌中的初步疗效观察

Observation on the preliminary efficacy of neoadjuvant immunotherapy combined with chemotherapy in non-small cell lung cancer

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