| Yi Chen,Nan Huang,Kai Qin,Jing Zhao,Huihua Xiong,Shiying Yu,Tingting Huang,QiuYun Guo. Comparison of intra-pleural injection efficac?between Endostar and Bevacizumab combined with pemetrexed/cisplatin for the treatment of malignant pleural effusion in patients with ?epidermal growth factor receptor-/anaplastic lymphoma kinase-lung adenocarcinoma. Oncol Transl Med, 2019, 5: 53-57. |
| 腔内使用恩度对比贝伐单抗联合培美曲塞/顺铂治疗EGFR-/ALK-肺腺癌患者恶性胸腔积液的疗效 |
| Comparison of intra-pleural injection efficac?between Endostar and Bevacizumab combined with pemetrexed/cisplatin for the treatment of malignant pleural effusion in patients with ?epidermal growth factor receptor-/anaplastic lymphoma kinase-lung adenocarcinoma |
| Received:March 29, 2019 Revised:May 07, 2019 |
| DOI：10.1007/s10330-019-0347-7 |
| 中文关键词: 恩度;贝伐单抗;恶性胸腔积液;EGFR-/ALK-肺腺癌;顺铂;培美曲塞;腔内治疗 |
| 英文关键词: ?Key words: Endostar; bevacizumab; malignant pleural effusion; EGFR-/ALK-lung adenocarcinoma; cisplatin; pemetrexed; intra-pleural injection |
| 基金项目:湖北省自然科学基金面上项目 2017CFB472 |
| Author Name | Affiliation | Department | | Yi Chen | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | Department of Oncology | | Nan Huang | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | Allergy Department | | Kai Qin | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hankou District, Wuhan, Hubei Province, China | Department of Oncology | | Jing Zhao | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hankou District, Wuhan, Hubei Province, China | Department of Oncology | | Huihua Xiong | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hankou District, Wuhan, Hubei Province, China | Department of Oncology | | Shiying Yu | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hankou District, Wuhan, Hubei Province, China | Department of Oncology | | Tingting Huang | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hankou District, Wuhan, Hubei Province, China | Department of Oncology | | QiuYun Guo* | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hankou District, Wuhan, Hubei Province, China | Department of Oncology |
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| 中文摘要: |
| 【摘要】目的：观察腔内应用恩度对比贝伐单抗联合培美曲塞/顺铂治疗EGFR-/ALK-肺腺癌患者恶性胸腔积液的疗效和安全性。
方法：收集2016 年1月至2017年6月收治的EGFR-/ALK-肺腺癌合并恶性胸腔积液患者共64例，随机分入恩度联合培美曲塞/顺铂组（恩度组）和贝伐单抗联合培美曲塞/顺铂组（贝伐单抗组），行胸腔穿刺置管引流尽胸腔积液。化疗方法均为培美曲塞 500mg/m2 ,静脉输注,d1，顺铂75 mg/m2 ,分2次,胸腔内注射,d1、d3。恩度组为30mg胸腔内用药2次，d1，3，贝伐单抗组为５mg/kg,胸腔内用药1次，d1。用药1周期，采集用药前及用药后7d胸腔积液,用ELISA方法检测VEGF水平。根据RECIST 1.1评价标准和NCI CTCAE 3.0评估疗效和不良反应。
结果：恩度组和贝伐单抗组ORR率分别为50.0%和56.3%，两者之间无显著性差异(P>0.05)。治疗前后两者胸腔积液VEGF水平均显著下降，下降水平之间无显著性差异(P>0.05)。两组治疗有效的患者化疗前VEGF水平显著高于无效的患者，差异具有统计学意义(P<0.05)。两组之间不良反应无明显差异。
结论：恩度和贝伐单抗联合培美曲塞/顺铂在EGFR-/ALK-肺腺癌合并恶性胸腔积液患者的MPE控制上具有同等效力，不良反应轻，VEGF水平可用于预测抗血管生成药物局部用药的疗效。 |
| 英文摘要: |
| Objective To compare intra-pleural injection efficacy and safety between Endostar and bevacizumab
combined with pemetrexed/cisplatin for the treatment of malignant pleural effusion in patients with epidermal
growth factor receptor (EGFR)-/anaplastic lymphoma kinase (ALK)-lung adenocarcinoma.
Methods Sixty-four pCVatients with EGFR-/ALK- lung adenocarcinoma with malignant pleural effusion
(MPE) were admitted to the authors’ hospital between January 2016 and June 2017. Patients were
randomly divided into two groups: Endostar combined with pemetrexed/cisplatin (Endostar group); and
bevacizumab plus pemetrexed/cisplatin (Bevacizumab group). They underwent thoracic puncture and
catheterization, and MPE was drained as much as possible. Both groups were treated with pemetrexed
500 mg/m2, intravenous drip (d1), cisplatin 37.5 mg/m2 per time, intra-pleural injection (d1, d3). Patients in
the Endostar group were treated with Endostar 30 mg per time, intra-pleural injection (d1, 3), and patients in
the Bevacizumab group were treated with bevacizumab 5 mg/kg per time, intra-pleural injection (d1). Only
one cycle of treatment was applied. MPE was extracted before treatment and on day 7 after treatment. The
levels of vascular endothelial growth factor (VEGF) were determined using ELISA. Efficacy and side effects
were evaluated according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, and
National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 criteria.
Results The objective response rates in the Endostar and Bevacizumab groups were 50.0% and 56.3%,
respectively; there was no statistical difference between the groups (P > 0.05). After one cycle of treatment,
the mean VEGF levels in MPE in both groups decreased significantly, and there was no significant difference
in the degree of decline between the two groups (P > 0.05). In both groups, pre-treatment VEGF levels
for patients achieving complete response were significantly higher than those for patients achieving stable
disease + progressive disease (P < 0.05). No specific side effects were recorded.
Conclusion Endostar and Bevacizumab demonstrated similar efficacy in controlling MPE in patients
with EGFR-/ALK- lung adenocarcinoma through an anti-angiogenesis pathway, with tolerable side effects.
The levels of VEGF in MPE could predict the efficacy of intra-pleural injection of anti-angiogenesis drugs. |
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