摘要
Abstract
Objective:To investigate the efficacy of oxaliplatin and docetaxel combined with programmed cell death re-ceptor-1/programmed cell death ligand-1(PD-1/PD-L1)inhibitors as a second-line treatment for stage Ⅳ non-small cell lung cancer(NSCLC)with negative driver genes,and study its safety to better guide clinical medication.Methods:A retro-spective analysis was conducted on 87 stage Ⅳ NSCLC patients with negative driver genes who underwent second-line treat-ment at our hospital from January 2019 to December 2020.Based on different second-line treatment approaches,the patients were assigned to the PD-1/PD-L1 group(n=44)and the oxaliplatin+docetaxel+PD-1/PD-L1 group(n=43).The study endpoints included objective response rate(ORR),disease control rate(DCR),overall survival(OS),progression-free survival(PFS)and safety.Results:There was no statistically significant difference in the ORR between the oxaliplatin+docetaxel+PD-1/PD-L1 group(4.65％)and the PD-1/PD-L1 group(2.27％)(x2=0.370,P=0.761).DCR in the oxaliplatin+docetaxel+PD-1/PD-L1 group(90.70％)was signifi-cantly higher than that in the PD-1/PD-L1 group(70.45％)(x2=5.668,P＜0.05).The OS and PFS rates in the oxalipla-tin+docetaxel+PD-1/PD-L1 group were significantly higher than those in the PD-1/PD-L1 group(46.51％vs 20.45％,x2=6.645,P＜0.05;25.58％vs 6.82％,x2=5.670,P＜0.05).The incidences of grade Ⅰ～Ⅱ and grade Ⅲ～Ⅳ bone marrow suppression in the oxaliplatin+docetaxel+PD-1/PD-L1 group were significantly higher than those in the PD-1/PD-L1 group(20.93％vs 0.00％,x2=10.272,P＜0.05;13.95％vs 0.00％,x2=6.594,P＜0.05).Conclusion:Oxali-platin and docetaxel combined with PD-1/PD-L1 inhibitors as a second-line treatment for stage Ⅳ NSCLC with negative driv-er genes demonstrates superior disease control,extending survival and progression-free survival,and achieving better treat-ment outcomes and prognosis.But attention should be paid to adverse reactions.关键词
奥沙利铂/多西他赛/程序性死亡受体-1/程序性死亡配体-1抑制剂/驱动基因阴性/IV期非小细胞肺癌Key words
Oxaliplatin/Docetaxel/PD-1/PD-L1 inhibitor/Negative driver gene/Stage Ⅳ non-small cell lung cancer分类
医药卫生
