Effects of nivolumab combined with pemetrexed on efficacy and prognosis in the treatment of advanced NSCLC

HUANG Xiaoli; WANG Lin; YANG Ting; LUO Lisha; ZHOU Yi; YANG Yi; MA Lihong

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Journal of Hunan Normal University(Medical Science) ›› 2023, Vol. 20 ›› Issue (3) : 43-46.

Clinical Medicine

Effects of nivolumab combined with pemetrexed on efficacy and prognosis in the treatment of advanced NSCLC

HUANG Xiaoli, WANG Lin, YANG Ting, LUO Lisha, ZHOU Yi, YANG Yi, MA Lihong

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Abstract

Objective To analyze the efficacy of programmed death receptor-1(PD-1) /programmed death receptor ligand-1(PD-L1) inhibitor nivolumab combined with pemetrexed in the treatment of advanced non-small cell lung cancer (NSCLC) and its effects on prognosis. Method A total of 98 patients with advanced NSCLC treated in the hospital from January 2018 to January 2021 were recruited and divided into observation group (49 cases, pemetrexed+ nivolumab) and control group (49 cases, pemetrexed) by the random number table method. Both groups of patients were continuously treated until intolerance or disease progression occurred. The clinical efficacy after treatment (2 cycles of chemotherapy) and adverse reactions during treatment in the two groups were recorded. The immune function (CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺), serum related factors [serum recombinant anterior gradient protein 2(AGR2), matrix metalloproteinase-9(MMP-9) ] and quality of life [Karnofsky Performance Status (KPS score) ] were compared between the two groups before and after treatment. Results There were no deaths in both groups within 2 cycles of chemotherapy, and the clinical objective response rate (ORR) of 57.14% in observation group was significantly higher than 36.73% in control group, and the absolute difference values of CD3⁺, CD8⁺, AGR2, MMP-9 and KPS score before and after treatment were significantly higher than those in control group while the absolute difference values of CD4⁺and CD4⁺/CD8⁺were significantly lower than those in control group. There were no significant differences in the adverse reactions between the two groups, and the patients with symptoms were well tolerated and controlled by 25%~50% down-regulated dose and symptomatic treatment. Conclusion Nivolumab combined with pemetrexed in the treatment of advanced NSCLC can improve the short-term relief effect, strengthen the body's immune function and enhance the quality of life, and it does not significantly increase the incidence rates of adverse reactions.

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NSCLC / PD-1/PD-L1 / pemetrexed / immune function / quality of life

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HUANG Xiaoli, WANG Lin, YANG Ting, LUO Lisha, ZHOU Yi, YANG Yi, MA Lihong. Effects of nivolumab combined with pemetrexed on efficacy and prognosis in the treatment of advanced NSCLC[J]. Journal of Hunan Normal University(Medical Science). 2023, 20(3): 43-46

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