目的 回顾性分析信迪利单抗联合化疗一线治疗晚期胃癌或胃食管结合部腺癌的疗效。方法 收集2019-01至2022-10解放军总医院第一医学中心收治的信迪利单抗联合化疗一线治疗晚期胃癌或胃食管结合部腺癌患者临床资料,分析入组患者中位无进展生存期(mPFS)、客观缓解率(ORR)及疾病控制率(DCR)。结果 共纳入71例患者,中位年龄60岁,男53例,女18例,其中45例给予信迪利联合以奥沙利铂为基础方案的治疗,26例给予信迪利联合以紫杉醇(白蛋白结合型)为基础方案的治疗。全组患者的ORR为67.6%,DCR为97.2%,mPFS为11.2个月(95% CI 9.7~12.8)。联合奥沙利铂为基础方案组的ORR为73.3%,DCR为97.8%,mPFS为11.3个月(95% CI 5.5~17.2)。联合紫杉醇(白蛋白结合型)为基础方案组的ORR为57.7%,DCR为96.2%,mPFS为10.9个月(95% CI 9.0~12.9),两组ORR及mPFS差异无统计学意义。结论 在晚期胃癌或胃食管结合部腺癌中,一线应用信迪利单抗联合化疗,患者无进展生存期明显获益。信迪利单抗联合以紫杉醇(白蛋白结合型)为基础的治疗组疗效与联合以奥沙利铂为基础治疗组相当。
Abstract
Objective To retrospectively analyze the efficacy of sintilimab combined with chemotherapy in the first-line treatment of advanced gastric or gastroesophageal junction adenocarcinoma(GC or GEJC). Methods Clinical data of patients with advanced GC or GEJC who received first-line sintilimab combined with chemotherapy at the First Medical Center of the Chinese PLA General Hospital from January 2019 to October 2022 were collected. Median progression-free survival (mPFS), objective response rate (ORR), and disease control rate (DCR) of enrolled patients were retrospectively analyzed. Results A total of 71 patients were included, with a median age of 60, including 53 males and 18 females. Forty-five patients were treated with sintilimab combined with oxaliplatin based regimen, while 26 patients were treated with sintilimab combined with albumin-bound paclitaxel (nab-paclitaxel) based regimen. The ORR, DCR and mPFS of all patients were 67.6%, 97.2% and 11.2 months (95% CI 9.7-12.8), respectively. The ORR, DCR and mPFS of oxaliplatin-based combination group were 73.3%, 97.8% and 11.3 months (95%CI 5.5-17.2), while the ORR, DCR and mPFS of nab-paclitaxel-based combination group were 57.7%, 96.2% and 10.9 months (95%CI 9.0-12.9). There was no significant difference in ORR and PFS between the two groups. Conclusions The first-line application of sintilimab combined with chemotherapy in advanced GC or GEJC can significantly benefit the mPFS of patients. In addition, the efficacy of sintilimab combined with nab-paclitaxel-based treatment is comparable with that with oxaliplatin-based treatment.
关键词
胃癌 /
信迪利单抗 /
一线治疗 /
奥沙利铂 /
紫杉醇(白蛋白结合型)
Key words
gastric cancer /
sintilimab /
first-line treatment /
Oxaliplatin /
nab-paclitaxel
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