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化疗联合卡瑞利珠单抗用于不可手术微卫星稳定型结直肠癌的

临床观察
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虞伟妃 ，汪笑秋 ，赵丽萍，冯继红，周珏伊（丽水市人民医院肿瘤放化疗科，浙江 丽水 323000）
中图分类号 R979.1 文献标志码 A 文章编号 1001-0408（2023）10-1242-05
DOI 10.6039/j.issn.1001-0408.2023.10.17

摘 要 目的 评价XELOX（奥沙利铂+卡培他滨）化疗联合抗血管生成剂（阿帕替尼）和免疫治疗药物（卡瑞利珠单抗）用于不可
手术转移性微卫星稳定（MSS）型结直肠癌（CRC）的疗效与安全性。方法 回顾性收集2020年1月－2021年1月丽水市人民医院
收治的40例不可手术转移性MSS型CRC患者的临床资料。根据治疗方案将患者分为对照组（20例）和观察组（20例）。对照组患
者接受XELOX+阿帕替尼治疗，观察组患者接受XELOX+阿帕替尼+卡瑞利珠单抗治疗。每3周为1个周期，连续治疗2个周期。
记录两组患者的客观缓解率（ORR）、疾病控制率（DCR）、无进展生存期（PFS）、总生存期（OS）和不良事件（AEs）发生情况。结果
观察组患者的ORR和DCR分别为65.0%、85.0%，对照组患者的ORR和DCR分别为35.0%、75.0%，组间比较差异均无统计学意义
（P＞0.05）。观察组和对照组患者的中位PFS分别为16.0、8.0个月，中位OS分别为19.0、12.5个月，组间比较差异均有统计学意义
（P＜0.05）。两组患者均至少发生1次AEs，且观察组患者的反应性皮肤毛细血管增生、甲亢的发生率均显著高于对照组（40.0%
vs. 0和20% vs. 0，P＜0.05），恶心和呕吐的发生率显著低于对照组（10% vs. 90%，P＜0.05）。观察组患者发生3级及以上AEs的有
14例（70.0%），而对照组仅有5例（25.0%），组间比较差异有统计学意义（P＜0.05）。但两组患者均未发生不能耐受或致命的严重
AEs，相关症状经停药或接受治疗后均得以缓解。结论 XELOX化疗联合阿帕替尼和卡瑞利珠单抗用于不可手术转移性MSS型
CRC患者的效果与XELOX化疗联合阿帕替尼相当，但具有一定的ORR、PFS和OS优势，且安全性可控。
关键词 不可手术；微卫星稳定型；转移性结直肠癌；化疗；免疫治疗；抗血管生成剂

Clinical observation of chemotherapy combined with camrelizumab in patients with inoperable
microsatellite stable type colorectal cancer
YU Weifei，WANG Xiaoqiu，ZHAO Liping，FENG Jihong，ZHOU Jueyi（Dept. of Chemoradiotherapy， Lishui
People’s Hospital， Zhejiang Lishui 323000， China）

ABSTRACT OBJECTIVE To evaluate the clinical efficacy and safety of XELOX chemotherapy （oxaliplatin+capecitabine）
combined with antiangiogenic agent （apatinib） and immunotherapy （camrelizumab） in patients with inoperable metastatic colorectal
cancer （CRC）of microsatellite stable （MSS） type. METHODS Clinical medical records of 40 patients with inoperable metastatic
CRC of MSS type treated in Lishui People’s Hospital from January 2020 to January 2021 were retrospectively collected. According
to the treatment plan， the patients were divided into control group （20 cases） and observation group （20 cases）. Control group was
given XELOX+apatinib regimen， while observation group was given XELOX+apatinib+camrelizumab regimen. Every 3 weeks was
a treatment cycle， and the treatment lasted for 2 consecutive cycles. The objective response rate （ORR）， disease control rate
（DCR）， progression-free survival （PFS）， overall survival （OS） and adverse events （AEs） were recorded for all patients.
RESULTS The ORR and DCR of observation group were 65.0% and 85.0%， respectively； and the ORR and DCR of control group
were 35.0% and 75.0%， respectively， with no statistical significance between 2 groups （P＞0.05）. The median PFS of observation
group and control groups were 16.0 months and 8.0 months， respectively； and the median OS were 19.0 months and 12.5 months，
respectively， with statistical significance between 2 groups （P＜0.05）. Each patient in both groups had at least one AEs， and the
incidences of reactive skin capillary hyperplasia and hyperthyroidism in observation group （40.0%， 20.0%） were significantly
higher than those in control group （both were 0） （P＜0.05）. The incidence of nausea and vomiting in control group （90%） was
significantly higher than observation group （10%） （P＜0.05）. There were 14 cases （70.0%） of patients with grade 3 or above AEs
in observation group， and only 5 cases （25.0%） in control group， with statistical significance between 2 groups （P＜0.05）.
However， no severe AEs that could not be tolerated or fatal occurred in the two groups， which could be alleviated after drug
withdrawal or treatment. CONCLUSIONS The efficacy of XELOX chemotherapy combined with apatinib and camrelizumab in
inoperable metastatic CRC patients of MSS type is comparable to that of XELOX chemotherapy combined with apatinib， but it has
certain advantages in ORR， PFS and OS， and controllable
Δ 基金项目 丽水市科技计划项目（No.2022SJZC032）
safety.
＊第一作者 主治医师。研究方向：乳腺癌。E-mail：yuweif123@ KEYWORDS inoperable； microsatellite stable type； meta-
163.com static colorectal cancer； chemotherapy； immunotherapy；
# 通信作者 副 主 任 医 师 。 研 究 方 向 ：临 床 医 学 。 E-mail： antiangiogenic agent
waxiaoq1234@163.com

· 1242 · China Pharmacy 2023 Vol. 34 No. 10 中国药房 2023年第34卷第10期