Objective To observe the clinical effect and safety of Pembrolizumab combined with Pemetrexed and Cisplatin (AP) chemotherapy in the treatment of advanced lung adenocarcinoma. Methods A total of 78 patients with locally advanced and advanced lung adenocarcinoma admitted to Department of Medical Oncology of Suzhou Hospital Affiliated to Nanjing Medical University from June 2018 to June 2020 were enrolled as the research objects retrospectively.According to different treatment methods, they were divided into AP chemotherapy group (n=37) and combination group(n=41). AP chemotherapy group was treated with AP chemotherapy (Pemetrexed 500 mg/m2 + Cisplatin 75 mg/m2),while combination group was treated with Pembrolizumab (200 mg) on basis of AP regimen. The curative effect, score of quality of life (QOL), progression-free survival (PFS), progression-free survival rate within 1 year and adverse reactions during treatment were compared between the two groups. Results The disease remission rate and disease control rate in combination group were higher than those in AP chemotherapy group, the differences were statistically significant (P<0.05). Improvement rate of quality of life in the combination group was higher than that in AP chemotherapy group, the difference was statistically significant (P<0.05). The progression-free survival rate within 1 year in combination group was higher than that in AP chemotherapy group, and PFS was longer than that in AP chemotherapy group, the differences were statistically significant (P<0.05). There was no significant difference in the incidence of adverse drug reactions between the two groups (P>0.05). Conclusion The short-term curative effect of Pembrolizumab combined with AP chemotherapy is more ideal, which can prolong survival time of patients to a certain extent, with few adverse reactions.And it provides new direction for clinical treatment of patients with advanced lung adenocarcinoma.
Siegel RL,Miller KD,Fuchs HE,et al.Cancer Statistics,2021[J].CA Cancer J Clin,2021,71(1):7-33.
[2]
Alexander M,Kim SY,Cheng H.Update 2020:Management of Non-Small Cell Lung Cancer[J].Lung,2020,198(6):897-907.
[3]
De Ruysscher D,Faivre-Finn C,Nackaerts K,et al.Recommendation for supportive care in patients receiving concurrent chemotherapy and radiotherapy for lung cancer[J].Ann Oncol,2020,31(1):41-49.
[4]
Park JH,Pyun WY,Park HW.Cancer metabolism:phenotype,signaling and therapeutic targets[J].Cells,2020,9(10):2308.
[5]
Borghaei H,Langer CJ,Gadgeel S,et al.24-Month overall survival from KEYNOTE-021 cohort g:pemetrexed and carboplatin with or without pembrolizumab as first-line therapy for advanced nonsquamous non-small cell lung cancer[J].J Thorac Oncol,2019,14(1):124-129.
[6]
Gadgeel S,Rodríguez-Abreu D,Speranza G,et al.Updated Analysis From KEYNOTE-189:Pembrolizumab or Placebo Plus Pemetrexed and Platinum for Previously Untreated Metastatic Nonsquamous Non-Small-Cell Lung Cancer[J].J Clin Oncol,2020,38(14):1505-1517.
[7]
Sezer A,Kilickap S,Gümüs M,et al.Cemiplimab monotherapy for first-line treatment of advanced non-small-cell lung cancer with PD-L1 of at least 50%:a multicentre,open-label,global,phase 3,randomised,controlled trial[J].Lancet,2021,397(10274):592-604.
Horn L,Spigel DR,Vokes EE,et al.Nivolumab versus docetaxel in previously treated patients with advanced nonsmall-cell lung cancer:two-year outcomes from two randomized,open-label,phase Ⅲtrials (checkmate 017 and checkmate 057)[J].J Clin Oncol,2017,35(35):3924-3933.
[18]
Ferrara R,Naigeon M,Auclin E,et al.Circulating T-cell Immunosenescence in Patients with Advanced Non-small Cell Lung Cancer Treated with Single-agent PD-1/PD-L1 Inhibitors or Platinum-based Chemotherapy[J].Clin Cancer Res,2021,27(2):492-503.
Vaddepally RK,Kharel P,Pandey R,et al.Review of indications of FDA-approved immune checkpoint inhibitors per NCCN Guidelines with the level of evidence[J].Cancers(Basel),2020,12(3):738.
[21]
Theelen WSME,Chen D,Verma V,et al.Pembrolizumab with or without radiotherapy for metastatic non-small-cell lung cancer:a pooled analysis of two randomised trials[J].Lancet Respir Med,2021,9(5):467-475.
[22]
Paz-Ares L,Luft A,Vicente D,et al.Pembrolizumab plus chemotherapy for squamous non-small-cell lung cancer[J].N Engl J Med,2018,379(21):2040-2051.
[23]
Wu YL,Zhang L,Fan Y,et al.Randomized clinical trial of pembrolizumab vs chemotherapy for previously untreated Chinese patients with PD-L1-positive locally advanced or metastatic non-small-cell lung cancer:KEYNOTE-042 China Study[J].Int J Cancer,2021,148(9):2313-2320.
[24]
Paladini L,da Veiga CRP,Cerqueira é,et al.Number needed to treat analysis applied to pembrolizumab plus chemotherapy for first-line treatment of non-squamous non-small cell lung cancer[J].J Med Econ,2021,24(1):1185-1193.
[25]
Garassino MC,Gadgeel S,Esteban E,et al.Patient-reported outcomes following pembrolizumab or placebo plus pemetrexed and platinum in patients with previously untreated,metastatic,non-squamous non-small-cell lung cancer (KEYNOTE-189):a multicentre,double-blind,randomised,placebo-controlled,phase 3 trial[J].Lancet Oncol,2020,21(3):387-397.