贝伐单抗联合化疗一线治疗晚期肺腺癌的疗效及安全性.docVIP

贝伐单抗联合化疗一线治疗晚期肺腺癌的疗效及安全性 于爱萍 屈清荣 李秀霞 (郑州大学第一附属医院 河南 郑州 450052 ) 【摘要】 目的 初步了解贝伐珠单抗联合标准化疗一线治疗晚期肺腺癌的疗效及安全性。方法 38例经病理学或细胞学确诊的晚期肺腺癌患者，均为初治，给予贝伐珠单抗7.5mg/kg联合紫杉醇/卡铂方案或联合培美曲塞/顺铂或卡铂方案治疗，每21天为1周期，每2周期进行疗效评价，达CR、PR和SD的患者4-6周期后继续贝伐珠单抗单药维持治疗，21天为1周期，直至病情进展或不能耐受。按照RECIST标准进行疗效评定和NCI CTC-AE第3版进行毒性反应评价。结果 38例患者中无CR，PR 22例（57.9%），SD 12例（31.6%），PD 4例（10.5%），总有效率（RR）为57.9%，疾病控制率（DCR）为89.5%。采用Log-rank单因素分析对可评价的11例晚期肺腺癌患者无进展生存时间（PFS）进行统计分析，结果显示PFS为6.9个月。全组患者毒性反应较轻，主要为乏力、骨髓抑制、消化道反应、高血压及蛋白尿，多为Ⅰ～Ⅱ级。结论 贝伐珠单抗联合标准化疗一线治疗晚期肺腺癌疗效较好、安全性较高。 【关键词】 贝伐珠单抗；化疗；一线治疗；晚期肺腺癌 [Abstract] Objective To evaluate the safety and efficacy of first-line bevacizumab with chemotherapy in the patients with advanced adenocarcinoma of lung. Methods A total of 38 patients with untreated, locally advanced, metastatic or recurrent adenocarcinoma of lung received up to six cycles of bevacizumab 7.5mg/kg every 3 weeks plus chemotherapy with paclitaxe/carboplatin or pemetrexed/cisplatin or carboplatin, then followed by single agent bevacizumab until disease progression or unacceptable toxicity. RECIST was used to assess the efficacy of the treatment, and NCI CTC-AE version 3.0 was used to describe adverse events. Result In 38 patients, 11 patients had partial response, 6 had stable disease and 2 had disease progression. The response rate was 57.9% and the disease control rate was 89.5. There are 11 patients could be evaluated for progression-free survival, the median PFS was 6.9 months. The principal drug-related adverse events were fatigue, myelosuppression, gastrointestinal response, hypertension and proteinuria; many were grade 1 to 2. Conclusion Bevacizumab with standard chemotherapy is well tolerated and active against advanced adenocarcinoma of lung, and worthy of further observation. [Key words] Bevacizumab; Chemotherapy; First-line; Advanced adenocarcinoma of lung 含铂双药联合化疗是晚期非小细胞肺癌（NSCLC）标准一线治疗方案，但是，对于一些特定人群，分子靶向药物的应用越来越显示出明显的疗效和生存优势，抗血管生成药物贝伐珠单抗即是其中之一。美国FDA于2006年10月、欧盟于2007年8月分别批准贝伐珠单抗联合标准化疗作为无法手术、局部复发