临床研究2025，Vol.33Issue(11)：74-78,5.DOI:10.12385/j.issn.2096-1278(2025)11-0074-05
阿替利珠单抗联合化疗治疗晚期驱动基因突变阴性NSCLC的效果及近远期预后观察
Efficacy of Atezolizumab Combined with Chemotherapy in Advanced Driver-Gene-Negative NSCLC and Observation of Short-and Long-Term Prognosis
摘要
Abstract
Objective To investigate the efficacy of atezolizumab combined with chemotherapy in treating advanced driver-gene-negative non-small cell lung cancer(NSCLC)and to observe short-and long-term prognosis.Methods A retrospective analysis was performed on patients diagnosed at Xinyang Central Hospital from January 2022 to January 2023 with unresectable,advanced(stage Ⅲ b～Ⅳ)driver-gene-negative NSCLC.According to treatment regimens,patients were divided into a chemotherapy group(paclitaxel plus cisplatin)and a monoclonal-antibody group(paclitaxel plus cisplatin combined with atezolizumab).A 1:1 propensity score matching method was used to balance confounding factors between groups,and 41 patients were finally included in the chemotherapy group and 41 in the monoclonal-antibody group.The recent efficacy of patients with different stages in the two groups was compared.Changes in tumor marker levels[cytokeratin 19 fragment antigen 21-1(CYFRA21-1),carcinoembryonic antigen(CEA),insulin-like growth factor-binding protein-2(IGFBP-2)]and T-lymphocyte subsets(CD3+,CD4+,and the CD4+/CD8+ratio)before and after treatment were assessed.Adverse reactions during treatment and long-term efficacy over a 2-year follow-up were recorded.Results The Objective response rate(ORR)and disease control rate(DCR)were higher in the monoclonal-antibody group than in the chemotherapy group,with statistically significant differences(P＜0.05);among patients with stage Ⅲ b disease,the DCR in the monoclonal-antibody group was higher than that in the chemotherapy group(P＜0.05).After treatment,CYFRA21-1,CEA,and IGFBP-2 decreased in both groups,with lower levels in the monoclonal-antibody group than in the chemotherapy group(P＜0.05).After treatment,CD3+,CD4+,and the CD4+/CD8+ratio increased in both groups,with higher values in the monoclonal-antibody group than in the chemotherapy group(P＜0.05).There was no statistically significant difference in adverse reactions between the chemotherapy and monoclonal-antibody groups(P＞0.05).Log-rank testing showed statistically significant differences between the groups in the Kaplan-Meier curves for median OS and median PFS(χ²=10.592 and 14.566,P＜0.05).Conclusion Paclitaxel plus cisplatin chemotherapy combined with atezolizumab provides definite efficacy in patients with advanced driver-gene-negative NSCLC,reduces tumor marker levels,mitigates decline in immune function,improves long-term survival,and demonstrates a favorable safety profile.关键词
阿替利珠单抗/化疗/晚期非小细胞肺癌/疗效/预后Key words
atezolizumab/chemotherapy/advanced non-small cell lung cancer/efficacy/prognosis分类
临床医学引用本文复制引用
段真珍,郑楠楠,禹哲,陈良新,任琦,胡伟..阿替利珠单抗联合化疗治疗晚期驱动基因突变阴性NSCLC的效果及近远期预后观察[J].临床研究,2025,33(11):74-78,5.基金项目
信阳市2022年度科技发展计划(20220078). （20220078）
