中国癌症防治杂志2025，Vol.17Issue(6)：697-704,8.DOI:10.3969/j.issn.1674-5671.2025.06.07
BAI/BACE联合铂类双药化疗及PD-1抑制剂治疗Ⅳ期驱动基因阴性非小细胞肺癌的临床疗效和安全性
Clinical efficacy and safety of BAI/BACE combined with platinum-based dual-drug chemo-therapy and PD-1 inhibitor in stage Ⅳ driver gene-negative non-small cell lung cancer
摘要
Abstract
Objective To investigate the clinical efficacy of bronchial arterial infusion(BAI)/bronchial arterial chemoembolization(BACE)combined with platinum-based dual-drug chemotherapy and PD-1 inhibitor as first-line treatment for stage Ⅳ driver gene-negative non-small cell lung cancer(NSCLC).Methods Clinical data of 91 patients with stage Ⅳ driver gene-negative NSCLC treated at the Chengdu Sixth People's Hospital between April 2020 and October 2024 were analyzed.Patients were categorized into two cohorts based on their treatment regimen:the BAI group(n=47)received BAI/BACE combined with platinum-based dual-drug chemotherapy and PD-1 inhibitor,and the non-BAI group(n=44)received platinum-based dual-drug chemotherapy and PD-1 inhibitor alone.Short-term efficacy,progression-free survival(PFS),overall survival(OS),and the incidence of adverse events(≥grade 1)within 90 days post-treatment were compared between the two groups.Results The objective response rate was significantly higher in the BAI group than in the non-BAI group(68.1%vs 47.7%,P=0.049).Additionally,the BAI group showed significantly better PFS(P=0.021)and OS(P=0.012),with median PFS of 12 months vs 8 months and median OS of 18 months vs 11 months.Two-stage analysis revealed that during the early stage(≤12 months),the BAI group demonstrated significantly superior PFS and OS compared to the non-BAI group(all P=0.003).Subgroup analysis of the BAI group showed a trend toward better PFS and OS in patients with central-type tumors com-pared to those with peripheral-type tumors(median PFS:15 months vs 11 months;median OS:21 months vs 16 months).Furthermore,in the advanced stage(>12 months),patients with central-type tumors demonstrated significantly better PFS(P=0.022)and OS(P=0.037)than those with peripheral-type tumors(median PFS:7 months vs 2 months;median OS:14 months vs 6 months).Multivariate Cox proportional hazards regression analysis confirmed that treatment with BAI/BACE combined with platinum-based dual-drug chemo-therapy and PD-1 inhibitor was an independent protective factor for both PFS and OS(all P<0.05).Adverse reactions in both groups were predominantly grade Ⅰ-Ⅱ,with no significant difference in incidence rates.Conclusions BAI/BACE combined with platinum-based dual-drug chemotherapy and PD-1 inhibitor demonstrated favorable efficacy and manageable safety in first-line treatment for stage Ⅳ driver gene-negative NSCLC patients,delivering significant survival benefits.关键词
非小细胞肺癌/支气管动脉灌注术/支气管动脉化疗栓塞术/免疫治疗/化疗Key words
Non-small cell lung cancer/Bronchial arterial infusion/Bronchial arterial chemoembolization/Immunotherapy/Che-motherapy分类
医药卫生引用本文复制引用
权小英,余家洋,冯礼夫,陈小艳,雷蕾,贾晓利,吴春芝,叶斌,黄琪越,罗敏,王宁..BAI/BACE联合铂类双药化疗及PD-1抑制剂治疗Ⅳ期驱动基因阴性非小细胞肺癌的临床疗效和安全性[J].中国癌症防治杂志,2025,17(6):697-704,8.基金项目
成都市医学科研课题(2022177) （2022177）
