Page 103 - 《中国药房》2023年20期

贝伐珠单抗与安罗替尼分别联合化疗药用于 EGFR-TKI 获得性

耐药晚期肺腺癌的临床观察
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齐彦宇 ，熊婷婷 ，张 军 ，汪 汉 ，周从明 ，蒋莎莎（1.成都市第三人民医院肿瘤科，成都 610404；2.四川
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省妇幼保健院/四川省妇女儿童医院/成都医学院附属妇女儿童医院临床药学科，成都 610031；3.成都市第三
人民医院心血管内科，成都 610404）
中图分类号 R979.1 文献标志码 A 文章编号 1001-0408（2023）20-2525-05
DOI 10.6039/j.issn.1001-0408.2023.20.14

摘 要 目的 比较贝伐珠单抗与安罗替尼分别联合化疗药用于表皮生长因子受体-酪氨酸激酶抑制剂（EGFR-TKI）获得性耐药
晚期肺腺癌的近期疗效和安全性。方法 回顾性分析2019年6月－2021年10月成都市第三人民医院治疗的84例EGFR-TKI获得
性耐药晚期肺腺癌患者资料，按用药的不同分为化疗组（32例）、安罗替尼联合化疗组（24例）和贝伐珠单抗联合化疗组（28例）。
化疗组患者给予注射用培美曲塞二钠+卡铂注射液，并对症治疗不良反应；安罗替尼联合化疗组患者在化疗组用药的基础上，于化
疗第1天口服盐酸安罗替尼胶囊10 mg，每日1次，连续用药14 d，停药7 d；贝伐珠单抗联合化疗组患者在化疗组用药的基础上，于
化疗前1 d给予贝伐珠单抗注射液15 mg/kg，静脉滴注。3组患者均以每3周为1个周期，共治疗4个周期。比较3组患者的总有效
率（ORR）、疾病控制率（DCR）、中位无进展生存期（mPFS），治疗前后血清中肿瘤标志物水平变化，并记录不良反应发生情况及随
访1年的生存率。结果 治疗4个周期后，两个联合化疗组患者的ORR、DCR均显著高于化疗组，mPFS均显著长于化疗组，且安罗
替尼联合化疗组患者的DCR显著高于贝伐珠单抗联合化疗组（P＜0.05）。治疗4个周期后，3组患者血清中肿瘤标志物水平均显
著低于同组治疗前，且两个联合化疗组均显著低于化疗组（P＜0.05）。3组患者恶心呕吐、骨髓抑制等不良反应发生率及1年生存
率比较，差异均无统计学意义（P＞0.05）。结论 贝伐珠单抗与安罗替尼分别联合化疗药用于EGFR-TKI获得性耐药晚期肺腺癌
的疗效和安全性均较好。
关键词 贝伐珠单抗；安罗替尼；表皮生长因子受体-酪氨酸激酶抑制剂；肺腺癌

Clinical observation of bevacizumab versus anlotinib respectively combined with chemotherapy drug in the
treatment of EGFR-TKI acquired resistant advanced lung adenocarcinoma
QI Yanyu ，XIONG Tingting ，ZHANG Jun ，WANG Han ，ZHOU Congming ，JIANG Shasha （1. Dept. of
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Oncology， the Third People’s Hospital of Chengdu， Chengdu 610404， China；2. Dept. of Clinical Pharmacy，
Sichuan Provincial Maternity and Child Health Hospital/Sichuan Provincial Hospital for Women and Children/the
Affiliated Women and Children’s Hospital of Chengdu Medical College， Chengdu 610031， China；3. Dept. of
Cardiology， the Third People’s Hospital of Chengdu， Chengdu 610404， China）
ABSTRACT OBJECTIVE To compare the short-term therapeutic effect and safety of bevacizumab versus anlotinib respectively
combined with chemotherapy drug in the treatment of epidermal growth factor receptor tyrosine kinase inhibitors （EGFR-TKI）
acquired resistant advanced lung adenocarcinoma. METHODS The information of 84 patients with EGFR-TKI acquired resistant
advanced lung adenocarcinoma in the Third People’s Hospital of Chengdu was analyzed retrospectively during Jun. 2019-Oct. 2021.
The patients were divided into chemotherapy group （32 cases）， anlotinib combined chemotherapy group （24 cases） and
bevacizumab combined chemotherapy group （28 cases）. Patients in the chemotherapy group were given Pemetrexed disodium for
injection and Carboplatin injection， and symptomatic treatment was given for adverse reactions. On the first day of chemotherapy，
patients in the anlotinib combined chemotherapy group received Anlotinib hydrochloride capsules 10 mg orally， once a day， for 14
consecutive days and 7 days of discontinuation， based on the treatment of the chemotherapy group. Patients in the bevacizumab
combined chemotherapy group were given Bevacizumab injection of 15 mg/kg intravenously 1 day before chemotherapy， based on
the treatment of the chemotherapy group. Three groups of patients were treated for a total of four cycles， with one cycle every three
weeks. The overall response rate （ORR）， disease control rate （DCR）， median progression-free survival （mPFS）， and the changes
of serum tumor markers were compared among three groups
Δ 基金项目 四川省科技计划项目（No.19YYJC0580）；成都市医 before and after treatment； meanwhile， the occurrence of
学科研课题（No.2022354） adverse drug reactions was recorded， and the 1-year survival rate
＊第一作者 主治医师，硕士。研究方向：肿瘤放化疗。电话：028- was followed up. RESULTS After 4 treatment cycles， ORR
67566088。E-mail：qiyanyu3@163.com and DCR of bevacizumab combined chemotherapy group and
# 通信作者 副主任医师，硕士。研究方向：肿瘤放化疗。电话： anlotinib combined chemotherapy group were higher than
028-67566088。E-mail：1106310943@qq.com chemotherapy group （P＜0.05）； mPFS of the two groups

中国药房 2023年第34卷第20期 China Pharmacy 2023 Vol. 34 No. 20 · 2525 ·