背景:培美曲塞(PEM)是非小细胞肺癌(NSCLC)的主要化疗药物,在某些情况下显示出长期疾病稳定性的潜力。然而,缺乏用PEM治疗检查疾病控制的研究。这项研究旨在确定对PEM治疗反应良好的NSCLC患者的临床特征,预测影响疾病控制的因素,并提出最佳治疗方法。
方法:对接受PEM治疗的非小细胞肺癌患者进行回顾性分析,比较治疗后疾病控制的患者与未治疗的患者。
结果:在73名患者中,56例(76.7%)通过PEM治疗实现了疾病控制。在疾病对照组中,显著较高比例的患者表现出良好的表现状态(PS),并且在第二个周期后接受PEM剂量而未减少.多因素分析确定贝伐单抗(Bev)不合规,PEM剂量减少,和甲状腺转录因子-1(TTF-1)阴性是PEM治疗期间疾病进展的重要独立危险因素。此外,疾病对照组的总生存期显著延长(p<0.001).
结论:我们的研究结果表明,非小细胞肺癌患者在第二个治疗周期后维持PEM的剂量,同时使用Bev和TTF-1阳性,可以提高疾病控制率并延长生存期。
BACKGROUND: Pemetrexed (PEM) is the primary chemotherapy for non-small cell lung cancer (NSCLC), showing potential for long-term disease stability in certain cases. However, studies examining disease control with PEM therapy are lacking. This study aimed to pinpoint clinical traits in patients with NSCLC responding well to PEM therapy, predict factors influencing disease control, and suggest optimal treatment approaches.
METHODS: A retrospective analysis of patients with NSCLC treated with PEM was performed to compare patients who achieved disease control after treatment with those who did not.
RESULTS: Of 73 patients, 56 (76.7%) achieved disease control with PEM therapy. In the disease control group, a significantly higher proportion of patients exhibited good performance status (PS) and received PEM doses without reduction after the second cycle. Multivariate analysis identified bevacizumab (Bev) noncompliance, PEM dose reduction, and thyroid transcription factor-1 (TTF-1) negativity as significant independent risk factors for disease progression during PEM therapy. Additionally, overall survival was significantly longer in the disease control group (p < 0.001).
CONCLUSIONS: Our findings indicated that maintaining the dose of PEM after the second treatment cycle in patients with NSCLC, along with concurrent use of Bev and the presence of TTF-1 positivity, could enhance disease control rates and extend survival.