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Clinical Study of Anti-PD-1 Immunotherapy Combined with Gemcitabine Chemotherapy in Multiline Treatment of Advanced Pancreatic Cancer
Computational and Mathematical Methods in Medicine ( IF 2.809 ) Pub Date : 2022-09-06 , DOI: 10.1155/2022/4070060
Yanfeng Liu 1 , Yanchuan Li 2 , Shan Du 3 , Li Fan 3 , Junyan Wang 3
Affiliation  

Objective. This study aimed to investigate the efficacy and safety of anti-PD-1 immunotherapy combined with gemcitabine chemotherapy in multiline treatment of advanced pancreatic cancer. Methods. A retrospective analysis was performed on the clinical data of 32 patients with advanced pancreatic cancer treated with sintilimab regimen from January 2019 to December 2021 in our hospital. All patients were followed up until death or April 2022, in the form of outpatient, in-hospital review, or telephone follow-up. Follow-up content included routine blood, liver and kidney functions, tumor markers, plain or enhanced abdominal CT, and abdominal MRI examinations. Clinical efficacy was evaluated according to mRECIST criteria, and the severity of adverse effects was evaluated according to American Institute for Cancer Research (AICR) Standard Term for Adverse Events, Version 5.0. Results. During treatment, the dosage of sintilimab was halved in 2 patients due to adverse reactions. All patients were treated with sintilimab for 1~10 times, with an average of times. The total response rate (ORR) and disease control rate (DCR) were 6.25% and 12.50% and 25.00% and 37.50%, respectively, after 1 and 3 months of treatment. The mean follow-up time of 32 patients was 1-12 months, and the median follow-up time was months. By the end point of follow-up, a total of 25 patients died, and the median progression-free survival (PFS) was 3.8 (95% CI (1.85-5.63)) months. The median overall survival (OS) was 5.1 months (95% CI (3.63~7.68). After treatment, the levels of tumor markers CA125, CEA and CA199 were partly decreased compared with those before treatment (all ). After treatment, the blood routine indexes d-dimer, CRP (C-reactive protein), NLR (neutral granulocyte to lymphocyte ratio), and MLR (monocyte to lymphocyte ratio) decreased compared with those before treatment. In 32 patients with advanced pancreatic cancer, the adverse reactions with an incidence more than 10% included fatigue, rash, hypothyroidism, hyperuricemia, and renal insufficiency. Only 2 patients showed grade 3 fatigue symptom, and all the others showed no adverse reactions of grades 3~5. In this study, all patients’ adverse reactions were relieved after symptomatic treatment. Conclusion. Gemcitabine chemotherapy in multiline treatment of advanced pancreatic cancer with sintilimab can achieve certain clinical benefits without serious adverse reactions.

中文翻译:

抗PD-1免疫治疗联合吉西他滨化疗多线治疗晚期胰腺癌的临床研究

客观。本研究旨在探讨抗PD-1免疫疗法联合吉西他滨化疗在晚期胰腺癌多线治疗中的有效性和安全性。方法。回顾性分析我院2019年1月至2021年12月接受信迪利单抗方案治疗的32例晚期胰腺癌患者的临床资料。所有患者均以门诊、住院复查或电话随访的形式进行随访,直至死亡或2022年4月。随访内容包括血常规、肝肾功能、肿瘤标志物、腹部平扫或增强CT、腹部MRI检查。根据mRECIST标准评估临床疗效,根据美国癌症研究所(AICR)不良事件标准术语5.0版评估不良反应的严重程度。结果。治疗期间,2例患者因不良反应而将信迪利单抗剂量减半。所有患者均接受信迪利单抗治疗1~10次,平均次。治疗1个月和3个月后,总有效率(ORR)和疾病控制率(DCR)分别为6.25%和12.50%、25.00%和37.50%。32名患者的平均随访时间为1-12个月,中位随访时间为几个月。截至随访终点,共有 25 名患者死亡,中位无进展生存期 (PFS) 为 3.8 (95% CI (1.85-5.63)) 个月。中位总生存期(OS)为5.1个月(95% CI(3.63~7.68)。治疗后肿瘤标志物CA125、CEA、CA199水平较治疗前部分下降(均)。治疗后血常规指标D-二聚体、CRP(C反应蛋白)、NLR(中性粒细胞与淋巴细胞比值)、MLR(单核细胞与淋巴细胞比值)较治疗前下降。32例晚期胰腺癌患者中,发生率超过10%的不良反应包括乏力、皮疹、甲状腺功能减退、高尿酸血症、肾功能不全等。仅2例患者出现3级疲劳症状,其余患者均未出现3~5级不良反应。本次研究中,所有患者的不良反应经过对症治疗后均得到缓解。结论。吉西他滨化疗联合信迪利单抗多线治疗晚期胰腺癌可取得一定的临床获益,且无严重不良反应。
更新日期:2022-09-06
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