10.1016/s1544-8800(12)70165-3

Vollständiger Abstract

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BACKGROUND: Most advanced non-small cell lung cancer (NSCLC) patients develop drug resistance after first-line treatment with limited subsequent options. Apatinib plus Sintilimab has therapeutic potential, but clinical evidence is scattered, and key factors like PD-L1 expression and gene mutations remain undefined. OBJECTIVE: Objective to explore the clinical efficacy of Apatinib combined with Sintilimab in the treatment of advanced NSCLC, and analyze the related factors affecting the efficacy, so as to provide reference for the formulation of clinical individualized treatment plan. METHOD: This study is a retrospective clinical study. 336 patients with advanced NSCLC treated in the Department of oncology of our hospital from May 2018 to May 2022 were selected. All patients received the combination therapy of Apatinib and Sintilimab. The observation indexes included the following main efficacy indexes: objective response rate (ORR), disease control rate (DCR), progression free survival (PFS), and overall survival (OS). The influencing factors were analyzed by univariate analysis (log rank test) and multivariate Cox proportional hazards regression model. RESULT: Results demonstrated that the ORR reached 34.5%, DCR was 72.6%, median PFS was 6.6 months (95% CI: 6.420-6.580), and median OS was 12.6 months (95% CI: 12.336-13.264). Univariate and multivariate Cox regression analyses verified that ECOG PS score of 0-1 and PD-L1 positivity were independent favorable prognostic factors for PFS and OS, whereas TNM stage IV, prior immunotherapy, EGFR mutation, and brain metastasis were independent unfavorable prognostic factors. Regarding safety, most adverse events were Grade 1-2, with fatigue being the most common, and no treatment-related mortality was observed. CONCLUSION: Apatinib plus Sintilimab in advanced NSCLC yields ORR 34.5% and DCR 72.6% with manageable safety. Favorable predictors: ECOG PS 0-1, Stage IIIB, and PD-L1+. Poor PFS/OS predictors: prior immunotherapy, EGFR mutation, and brain metastasis.

Abstract: PubMed · Datensatz