卡瑞利珠单抗联合培美曲塞、卡铂治疗晚期肺腺癌的疗效: 一项随机对照试验

Efficacy of camrelizumab combined with pemetrexed and carboplatin in the treatment of advanced lung adenocarcinoma: a randomised controlled trial

  • 摘要:
    目的 分析卡瑞利珠单抗联合培美曲塞、卡铂治疗晚期肺腺癌的疗效及对血清干扰素-γ(IFN-γ)、半乳糖凝集素3(Gal-3)水平的影响。
    方法 选择2023年1月—2024年1月收治的晚期肺腺癌患者197例为研究对象,采用简单随机法分为单纯化疗组(n=98, 培美曲塞+卡铂)和卡瑞利珠组(n=99, 卡瑞利珠+培美曲塞+卡铂)。比较2组疗效、血清肿瘤相关因子癌胚抗原(CEA)、糖类抗原125(CA125)、免疫功能指标CD3+、CD4+、CD4+/CD8+、血清相关因子(IFN-γ、Gal-3)及安全性。
    结果 卡瑞利珠组缓解率(ORR)和获益率(DCR)均高于单纯化疗组, 差异有统计学意义(P < 0.05)。治疗后, 2组CEA、CA125、Gal-3水平均下降,且卡瑞利珠组低于单纯化疗组,差异有统计学意义(P < 0.05)。治疗后, 2组CD3+、CD4+、CD4+/CD8+、IFN-γ均升高, 且卡瑞利珠组高于单纯化疗组,差异有统计学意义(P < 0.05)。2组治疗后心理、社会及躯体功能及物质生活评分均升高,且卡瑞利珠组以上评分高于单纯化疗组,差异有统计学意义(P < 0.05); 卡瑞利珠组与单纯化疗组消化道反应、皮疹、恶心呕吐等总不良反应发生率差异无统计学意义(P < 0.05)。
    结论 卡瑞利珠单抗联合培美曲塞、卡铂治疗晚期肺腺癌的临床疗效显著,可有效降低Gal-3、肿瘤相关因子水平,提升IFN-γ水平和免疫功能,且未增加不良反应。

     

    Abstract:
    Objective To analyze the efficacy of camrelizumab combined with pemetrexed and carboplatin in the treatment of advanced lung adenocarcinoma and its impact on serum interferon-γ (IFN-γ) and galectin-3 (Gal-3) levels.
    Methods A total of 197 patients with advanced lung adenocarcinoma admitted from January 2023 to January 2024 were selected as the study subjects. They were randomly divided into chemotherapy-alone group (n=98, pemetrexed+carboplatin) and camrelizumab group (n=99, camrelizumab+pemetrexed+carboplatin) using a simple randomisation method. The efficacy, serum tumour-related factorscarcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), immune function indicators CD3+, CD4+, CD4+/CD8+, serum-related factors (IFN-γ, Gal-3), and safety were compared between the two groups.
    Results The objective response rate (ORR) and disease control rate (DCR) in the camrelizumab group were higher than those in the chemotherapy-alone group, with statistically significant differences (P < 0.05). The levels of CEA, CA125, and Gal-3 after treatment decreased in both groups, and their levels in the camrelizumab group were lower than those in the chemotherapy-alone group, with statistically significant differences (P < 0.05). The levels of CD3+, CD4+, CD4+/CD8+, and IFN-γ increased in both groups, and the levels in the camrelizumab group were higher than those in the chemotherapy-alone group, with statistically significant differences (P < 0.05). After treatment, the scores of psychological, social, physical function, and material life increased in both groups, and their scores in the camrelizumab group were higher than those in the chemotherapy-alone group, with statistically significant differences (P < 0.05). There was no statistically significant difference in the overall incidence of adverse reactions such as gastrointestinal reactions, rash, nausea, and vomiting between the camrelizumab group and the chemotherapy-alone group (P < 0.05).
    Conclusion Camrelizumab combined with pemetrexed and carboplatin has significant clinical efficacy in the treatment of advanced lung adenocarcinoma. It can effectively reduce Gal-3 and tumour-related factors levels, increase IFN-γ levels and immune function, and does not increase adverse reactions.

     

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