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中国癌症防治杂志

中国癌症防治杂志 ›› 2024, Vol. 16 ›› Issue (5): 598-605.doi: 10.3969/j.issn.1674-5671.2024.05.14

• 临床研究 • 上一篇    下一篇

呋喹替尼联合免疫检查点抑制剂在微卫星稳定型转移性结直肠癌患者后线治疗中的疗效和安全性

  

  1. 武汉大学人民医院肿瘤科
  • 出版日期:2024-10-25 发布日期:2024-11-06
  • 通讯作者: 陈永顺 E-mail：cyszlsk@163.com
  • 基金资助:
    湖北省中央引导地方科技发展资金专项（ZYYD2020000169）

Efficacy and safety of Fruquintinib combined with immune checkpoint inhibitors in later-line treatment of patients with microsatellite stable metastatic colorectal cancer

  • Online:2024-10-25 Published:2024-11-06

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摘要： 目的 评估呋喹替尼单药或联合免疫检查点抑制剂（immune checkpoint inhibitor, ICI）在微卫星稳定（microsatellite⁃stable, MSS）型转移性结直肠癌（metastatic colorectal cancer, mCRC）患者三线及以上治疗中的疗效和安全性。方法 选择2020年1月至2024年4月在武汉大学人民医院肿瘤科接受治疗的pMMR/MSS型mCRC患者为研究对象。在未调整模型和倾向性匹配中比较呋喹替尼单药或呋喹替尼联合ICI的预后、疗效以及安全性。结果 共104例患者纳入分析，其中呋喹替尼组33例，呋喹替尼联合ICI组71例。与呋喹替尼组相比，呋喹替尼联合ICI组的中位无进展生存期更长（3.0个月vs 4.5个月；HR=0.55，95%CI：0.33~0.89）；但两组的中位总生存期（10.1个月 vs 13.1个月）、客观缓解率（9.1% vs 11.3%）、疾病控制率（51.5% vs 66.2%）比较，差异均无统计学意义（均P>0.05）。倾向性匹配分析亦获得类似的结果。两组3级及以上不良事件均主要包括手足皮肤反应、血小板减少和白细胞减少；其中呋喹替尼组3级及以上不良事件的发生率为30.3%，呋喹替尼联合ICI组为36.6%（P=0.529）。结论 相比于呋喹替尼，呋喹替尼联合ICI可为pMMR/MSS型mCRC患者的三线及以上治疗带来无进展生存期获益，安全性可控，值得进一步研究。

关键词: 转移性结直肠癌, 微卫星稳定, 呋喹替尼, 免疫检查点抑制剂, 后线治疗

Abstract: Objective To evaluate the efficacy and safety of fruquintinib alone or in combination with immune checkpoint inhibitor (ICI) in patients with microsatellite stable (MSS) metastatic colorectal cancer (mCRC)in third⁃line or above treatment. Methods Patients with pMMR/MSS type mCRC admitted to the Department of Oncology, Renmin Hospital of Wuhan University, from January 2020 to April 2024 were selected as the research objects. The prognoses, efficacies and safeties of fruquintinib alone and in combination with ICI were compared in the unadjusted model and the propensity score matching. Results A total of 104 patients were included in the analysis, 33 in the fruquintinib group and 71 in the fruquintinib combined with ICI group. Compared to the fruquintinib group, the median progression⁃free survival was longer in the fruquintinib combined ICI group (3.0 months vs 4.5 months; HR=0.55, 95%CI: 0.33-0.89）. However, there were no significant differences in the median overall survival (10.1 months vs 13.1 months）, the objective response rate (9.1% vs 11.3%) and the disease control rate (51.5% vs  66.2%)between the two groups (all P>0.05）. Similar results were obtained in the analysis of the propensity score matching. The adverse events of grade 3 or above in both groups mainly included hand⁃foot⁃skin reaction, thrombocytopenia and leukopenia. The incidence of grade 3 or above adverse events was 30. 3% in the fruquintinib group and 36.6% in the fruquintinib combined with ICI group (P=0.529）. Conclusions Compared with fruquintinib, fruquintinib combined with ICI provides benefits in the progression⁃free survival for pMMR/MSS type mCRC patients in third⁃line or above treatment with controllable safety, which is worthy of further study.

Key words: Metastatic colorectal cancer, Microsatellite stable, Fruquintinib, Immune checkpoint inhibitor, Later?line treatment

中图分类号: 

  • R735.3+5