阿特珠单抗联合安罗替尼治疗晚期非小细胞肺癌疗效观察

国际肿瘤学杂志››2025,Vol. 52››Issue (8): 495-501.doi:10.3760/cma.j.cn371439-20241108-00084

阿特珠单抗联合安罗替尼治疗晚期非小细胞肺癌疗效观察

赵芳¹, 姜国荣², 史淑月³, 肖剑¹, 马少林⁴, 李润浦¹()

¹保定市第二中心医院呼吸与危重症医学科，保定 072750
²保定市第二中心医院CT室，保定 072750
³保定市第二中心医院内分泌科，保定 072750
⁴保定市第二中心医院肿瘤科，保定 072750

收稿日期:2024-11-08修回日期:2025-03-04出版日期:2025-08-08发布日期:2025-09-15
通讯作者:李润浦 E-mail:lirunpu@sina.com
基金资助:
保定市科技计划(2341ZF043)

Observation on the therapeutic effect of atezolizumab combined with anlotinib in treating advanced non-small cell lung cancer

Zhao Fang¹, Jiang Guorong², Shi Shuyue³, Xiao Jian¹, Ma Shaolin⁴, Li Runpu¹()

¹Department of Respiratory and Critical Care Medicine， Baoding No.2 Central Hospital， Baoding 072750， China
²Department of CT Room， Baoding No.2 Central Hospital， Baoding 072750， China
³Department of Endocrinology， Baoding No.2 Central Hospital， Baoding 072750， China
⁴Department of Oncology， Baoding No.2 Central Hospital， Baoding 072750， China

Received:2024-11-08Revised:2025-03-04Online:2025-08-08Published:2025-09-15
Contact:Li Runpu E-mail:lirunpu@sina.com
Supported by:
Science and Technology Plan of Baoding(2341ZF043)

摘要/Abstract

摘要：

目的探讨阿特珠单抗联合安罗替尼治疗晚期非小细胞肺癌（NSCLC）的疗效。方法选取2019年9月至2023年9月保定市第二中心医院收治的经二线治疗后进展的80例晚期NSCLC患者作为研究对象，将单纯采用安罗替尼治疗的患者纳入单药组（n=40），采用阿特珠单抗联合安罗替尼治疗的患者纳入联合组（n=40），比较两组患者临床疗效及血清癌胚抗原（CEA）、血管内皮生长因子（VEGF）水平；通过Kaplan-Meier生存曲线分析两组患者的生存情况；采用肺癌治疗功能评价量表（FACT-L）评估两组患者治疗前、后的生命质量；比较两组患者不良反应发生情况。结果治疗4个周期后，联合组患者客观缓解率（ORR）为37.50%（15/40），高于单药组的17.50%（7/40），差异有统计学意义（χ²=4.01，P=0.045），两组疾病控制率（DCR）分别为85.00%（34/40）、75.00%（30/40），差异无统计学意义（χ²=1.25，P=0.264）。治疗前，联合组与单药组患者血清CEA水平分别为（10.18±2.15）、（10.14±2.02）μg/L，VEGF水平分别为（804.04±46.58）、（809.10±43.63）ng/L，差异均无统计学意义（均P>0.05）；治疗后，联合组与单药组患者CEA水平分别为（4.35±1.05）、（6.63±1.37）μg/L，VEGF水平分别为（431.26±50.19）、（549.92±55.27）ng/L，差异均有统计学意义（t=8.35，P<0.001；t=10.05，P<0.001），且两组患者治疗后血清CEA、VEGF水平均较治疗前降低（t=32.47，P<0.001；t=21.73，P<0.001；t=88.65，P<0.001；t=58.27，P<0.001）。生存分析显示，单药组和联合组患者的中位无进展生存期（PFS）分别为4.12、6.06个月，差异有统计学意义（χ²=17.70，P<0.001），中位总生存期（OS）分别为11.8、12.7个月，差异无统计学意义（χ²=3.09，P=0.079）。治疗前，联合组与单药组患者的FACT-L评分分别为（61.20±6.98）、（60.52±7.14）分，差异无统计学意义（t=0.43，P=0.668）；治疗后，两组患者的FACT-L评分分别为（83.24±9.38）、（74.58±7.86）分，差异有统计学意义（t=4.48，P<0.001），且两组患者治疗后的FACT-L评分均高于治疗前（t=29.36，P<0.001；t=21.51，P<0.001）。治疗期间，两组患者药物相关不良反应总发生率分别为42.50%（17/40）、55.00%（22/40），差异无统计学意义（χ²=1.25，P=0.263）。结论阿特珠单抗联合安罗替尼治疗晚期NSCLC能够提升短期疗效，延长患者PFS，改善患者生命质量，且相关不良反应可耐受。

关键词:癌，非小细胞肺,阿特珠单抗,安罗替尼,治疗结果

Abstract:

ObjectiveTo explore the efficacy of atezolizumab combined with anlotinib in treating advanced non-small cell lung cancer （NSCLC）.MethodsA total of 80 patients with advanced NSCLC treated in the Baoding No.2 Central Hospital from September 2019 to September 2023 after second-line treatment were selected as research subjects. Patients who received only anlotinib treatment were included in the monotherapy group （n=40）， while patients who received atezolizumab combined with anlotinib treatment were included in the combination group （n=40）. The clinical efficacy and serum levels of carcinoembryonic antigen （CEA） and vascular endothelial growth factor （VEGF） of the two groups were compared. Kaplan-Meier survival curve was used to analyze the survival of the two groups. The functional assessment of cancer therapy-lung cancer （FACT-L） was used to assess the quality of life of patients in both groups before and after treatment. The incidence of adverse reactions was compared between the two groups.ResultsAfter four cycles of treatment， the objective response rate （ORR） of the combination group was 37.50% （15/40）， which was higher than that of the monotherapy group [17.50% （7/40）]， with a statistically significant difference （χ²=4.01，P=0.045）. The disease control rates （DCRs） of the two groups were 85.00% （34/40） and 75.00% （30/40）， respectively， with no statistically significant difference （χ²=1.25，P=0.264）. Before treatment， the CEA levels in combination group and monotherapy group were （10.18±2.15） and （10.14±2.02） μg/L， and the VEGF levels were （804.04±46.58） and （809.10±43.63） ng/L， respectively， with no statistically significant difference （bothP>0.05）. After treatment， the serum CEA levels of patients in combination group and monotherapy group were （4.35±1.05） and （6.63±1.37） μg/L， and the VEGF levels were （431.26±50.19） and （549.92±55.27） ng/L， respectively， with statistically significant differences （t=8.35，P<0.001；t=10.05，P<0.001）， and the levels of serum CEA and VEGF in the two groups after treatment were lower than before treatment （t=32.47，P<0.001；t=21.73，P<0.001；t=88.65，P<0.001；t=58.27，P<0.001）. Survival analysis showed that the median progression-free survival （PFS） of the monotherapy group and the combination group were 4.12 and 6.06 months， respectively， with a statistically significant difference （χ²=17.70，P<0.001）， the median overall survival （OS） were 11.8 and 12.7 months， respectively， with no statistically significant difference （χ²=3.09，P=0.079）. Before treatment， the FACT-L scores of patients in combination group and monotherapy group were 61.20±6.98 and 60.52±7.14， respectively， with no statistically significant difference （t=0.43，P=0.668）. After treatment， the FACT-L scores of the two groups were 83.24±9.38 and 74.58±7.86， respectively， with a statistically significant difference （t=4.48，P<0.001）， and the FACT-L scores of the two groups after treatment were all higher than before treatment （t=29.36，P<0.001；t=21.51，P<0.001）. During treatment， the total incidence of drug-related adverse reactions in two groups was 42.50% （17/40） and 55.00% （22/40）， respectively， with no statistically significant difference （χ²=1.25，P=0.263）.ConclusionsAtezolizumab combined with anlotinib in the treatment of advanced NSCLC can enhance the short-term efficacy， prolong the PFS of patients， improve the quality of life， and the related adverse reactions are tolerable.

Key words:Carcinoma， non-small-cell lung,Atezolizumab,Anlotinib,Treatment outcome

赵芳, 姜国荣, 史淑月, 肖剑, 马少林, 李润浦. 阿特珠单抗联合安罗替尼治疗晚期非小细胞肺癌疗效观察[J]. 国际肿瘤学杂志, 2025, 52(8): 495-501.

Zhao Fang, Jiang Guorong, Shi Shuyue, Xiao Jian, Ma Shaolin, Li Runpu. Observation on the therapeutic effect of atezolizumab combined with anlotinib in treating advanced non-small cell lung cancer[J]. Journal of International Oncology, 2025, 52(8): 495-501.

图/表6

组别	性别	年龄（岁）	TNM分期		病理类型	合并高血压	吸烟史
联合组（n=40）	28（70.00）	12（30.00）	62.11±9.76	10（25.00）	30（75.00）		26（65.00）	14（35.00）	5（12.50）	16（40.00）
单药组（n=40）	26（65.00）	14（35.00）	61.80±9.19	9（22.50）	31（77.50）		29（72.50）	11（27.50）	6（15.00）	18（45.00）
χ²/t值	0.23	0.16	0.07		0.52	0.11	0.21
P值	0.633	0.884	0.793		0.469	0.745	0.651

表1

组别	CR	PR	SD	PD	客观缓解	疾病控制
联合组（n=40）	0（0）	15（37.50）	19（47.50）	6（15.00）	15（37.50）	34（85.00）
单药组（n=40）	0（0）	7（17.50）	23（57.50）	10（25.00）	7（17.50）	30（75.00）
χ²值					4.01	1.25
P值					0.045	0.264

表2

组别	CEA（μg/L）	t值	P值	VEGF（ng/L）	t值	P值
联合组（n=40）	10.18±2.15	4.35±1.05	32.47	<0.001	804.04±46.58	431.26±50.19	88.65	<0.001
单药组（n=40）	10.14±2.02	6.63±1.37	21.73	<0.001	809.10±43.63	549.92±55.27	58.27	<0.001
t值	0.09	8.35			0.50	10.05
P值	0.932	<0.001			0.617	<0.001

表3

图1

组别	FACT-L评分	t值	P值
联合组（n=40）	61.20±6.98	83.24±9.38	29.36	<0.001
单药组（n=40）	60.52±7.14	74.58±7.86	21.51	<0.001
t值	0.43	4.48
P值	0.668	<0.001

表4

组别	毛细血管扩张症	高血压	乏力	手足综合征	总发生情况
联合组（n=40）	9（22.50）	3（7.50）	2（5.00）	3（7.50）	17（42.50）
单药组（n=40）	8（20.00）	6（15.00）	4（10.00）	4（10.00）	22（55.00）
χ²值					1.25
P值					0.263

表5

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