Clinical Study of Endostar Combined with Pemetrexed for Advanced Non-small Cell Lung Cancer
|School||Dalian Medical University|
|Keywords||Non-small cell lung cancer (NSCLC) Endostatin Pemetrexed|
Objective To observe the recombinant human endostatin (ex degrees) combined with pemetrexed second-line treatment of advanced non-small cell lung cancer (NSCLC) the efficacy, safety and quality of life conditions. Methods of collecting September 2008 to September 2010 in the First Affiliated Hospital of Dalian Medical treatment of histologically or cytologically confirmed, first-line use of NP / TP / GP regimen progress, and not used Endostar and pemetrexed Qu plug IIIB-IV non-small cell lung cancer patients, 60 patients between the ages of 43-71 years old, with a median age of 61 years, KPS score between 70-90, male 35 cases, female 25 cases; adenocarcinoma 28 cases, 19 cases of squamous cell carcinoma, adenosquamous carcinoma in 13 cases; IIIB period 22 cases, IV period 38 cases; line using the TP scheme 19 cases, NP programs 17 cases, GP program 24 cases. 26 cases received endostar pemetrexed therapy 2-6 cycles, with an average 3.1 cycles (test group, Endostar 15ml / times / day, add 500ml saline infusion on days 1-14; pemetrexed Cypriot 500mg/m2 add 100ml saline infusion on day 1, 21 days for 1 cycle); 34 cases received pemetrexed monotherapy 2-6 cycles, with an average 3.4 cycles (control group, pemetrexed 500mg / m2 add 100ml saline infusion on day 1, 21 days for 1 cycle). Evaluation criteria in accordance with the treatment of solid tumors (RECIST) recently evaluated the efficacy and observe the progression-free survival (PFS) and survival (OS), with reference to Karnofsky score (KPS) evaluate changes in quality of life (QOL), every 2-cycle assessment; according to WHO criteria to evaluate the adverse reactions per cycle assessment. Experimental group, the objective response rate was CR0% (0), PR 19.2% (5/26), SD 61.4% (16/26), PD 19.2% (5/26), the total efficiency RR (CR PR) is 19.2% (5/26), disease control rate (DCR) (CR PR SD) was 80.7% (21/26); median progression-free survival (mPFS) was 2.7 months, median survival time (MST) for the 6.0 months. Control group CR 0% (0), PR14.7% (5/34), SD41.2% (14/34), PD44.1% (15/34), RR was 14.7% (5/34), DCR was 55.9% (19/34); median progression-free survival (mPFS) was 2.6 months, median survival time (MST) was 5.8 months. The two groups, the total efficiency (RR), the median progression-free survival (mPFS) and median survival time (MST) showed no significant difference between (P gt; 0.05), but the disease control rate (DCR) difference statistically significant (P lt; 0.05). Chemotherapy side effects in both groups was mainly hematologic toxicity and gastrointestinal reactions. Test group neutrophils, platelets and hemoglobin reduction rates were 30.7%, 13.6%, 13.6%, III-IV degree reduce the incidence rate was 3.8%, 0,0; control group neutrophils, platelets and hemoglobin reduce the incidence rates were 32.4%, 11.8%, 11.8%, III-IV degree reduce the incidence rate was 0. Gastrointestinal effects include nausea, vomiting and liver damage. The incidence of nausea and vomiting in the two groups were 30.8%, 32.4%, III-IV rate was 3.8%, 0; liver damage rates were 23.1%, 26.5%, III-IV incidence 0,2.9%; There were no febrile neutropenia and arrhythmia occurrence of adverse events. There was no statistical difference between adverse reactions (P gt; 0.05). Two sets of quality of life improvement rate of 30.8%, 26.5%, was not statistically significant (P gt; 0.05). Conclusions 1. Endostar pemetrexed second-line treatment of advanced NSCLC in the disease control rate was superior pemetrexed alone group; in progression-free survival and survival were similar between groups; 2. Endostar pemetrexed second-line treatment of advanced NSCLC safety, does not increase the side effects of chemotherapy, the patient tolerated.