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安罗替尼联合TP方案对晚期NSCLC患者炎症反应及肿瘤标志物的影响

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  • 河南省中医院肿瘤科, 河南 郑州 450002
胡斌,男,硕士,主治医师,研究方向:临床肺癌

收稿日期: 2025-10-15

  修回日期: 2025-10-29

  录用日期: 2026-04-01

  网络出版日期: 2026-04-01

Effects of Anlotinib Combined with TP Chemotherapy Regimen on Inflammatory Response and Tumor Markers in Patients with Advanced Non-Small Cell Lung Cancer

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  • Department of Oncology, Henan Provincial Hospital of Traditional Chinese Medicine, Henan Zhengzhou 450002, China

Received date: 2025-10-15

  Revised date: 2025-10-29

  Accepted date: 2026-04-01

  Online published: 2026-04-01

摘要

目的:探讨在标准紫杉醇联合顺铂(TP)化疗方案基础上加入安罗替尼治疗对晚期进展性非小细胞肺癌(NSCLC)患者的效果,并进一步分析其对血清炎症因子与肿瘤相关标志物的调控作用。方法:回顾性分析2020年4月至2025年4月在我院确诊并接受系统治疗的94例晚期进展性NSCLC患者。其中47例接受常规TP方案化疗(对照组),另外47例在TP化疗基础上加用安罗替尼(观察组)。比较两组患者的实体瘤疗效与安全性,并随访12个月,统计生存情况、无进展生存期(PFS)和总生存期(OS)。采用Kaplan-Meier法绘制生存曲线,并通过Log-rank检验比较两组间PFS及OS差异。另于治疗前及4个疗程后检测血清中肿瘤[癌胚抗原(CEA)、糖类抗原125(CA125)、细胞角蛋白19片段(Cyfra21-1)]与炎症[白细胞介素-2(IL-2)、IL-10、干扰素-γ(IFN-γ)]相关因子水平。结果:治疗结束后,观察组疾病控制率(DCR)优于对照组(P<0.05)。安全性方面,观察组患者在治疗期间出现蛋白尿及高血压的总发生率高于对照组(P<0.05)。随访结果显示,对照组PFS为(6.95±1.71)个月,死亡28例,OS为(7.42±1.67)个月;观察组PFS为(8.26±2.34)个月,死亡17例,OS为(10.63±1.92)个月,二者差异均有统计学意义(χ2=7.986、8.012,P<0.05)。治疗后,两组CEA、CA125、Cyfra21-1及IL-10水平均下降,而IL-2与IFN-γ水平均较治疗前升高,且观察组变化更为突出(P<0.05)。结论:在TP化疗方案中联合安罗替尼用于晚期进展性NSCLC的治疗,可显著提高疾病控制率,并有效延长PFS与OS。同时,该联合方案在降低肿瘤标志物水平、改善炎症因子平衡方面亦表现出积极作用,提示其可能通过调节免疫微环境减轻肿瘤负担。安罗替尼的使用也伴随一定的不良反应风险,如蛋白尿与高血压,临床中应加强个体化监测与用药。
    

本文引用格式

胡斌, 董良 . 安罗替尼联合TP方案对晚期NSCLC患者炎症反应及肿瘤标志物的影响[J]. 中国药物评价, 2026 , 43(1) : 56 -56-61 . DOI: magtech-2025-10-15-00001

Abstract

Objective: To evaluate the efficacy of anlotinib in combination with standard paclitaxel plus cisplatin (TP) chemotherapy in patients with advanced progressive non-small cell lung cancer (NSCLC), and to explore its effects on serum inflammatory cytokines and tumor markers. Methods: A retrospective analysis was conducted on 94 patients with advanced progressive NSCLC who were diagnosed and received systematic treatment in our hospital from April 2020 to April 2025. Among them, 47 patients received standard TP chemotherapy (control group), while the other 47 patients received TP chemotherapy combined with oral anlotinib (observation group). Tumor response and safety were compared between the two groups, and the patients were followed up for 12 months to assess survival outcomes, including progression-free survival (PFS) and overall survival (OS). Survival curves were plotted using the Kaplan-Meier method, and PFS and OS of the two groups were compared through the Log-rank test. Serum levels of tumor markers [carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), cytokeratin 19 fragment (Cyfra21-1)] and inflammatory factors [interleukin-2 (IL-2), IL-10, interferon-γ (IFN-γ)] were measured before treatment and after four cycles of therapy. Results: After treatment, the disease control rate (DCR) in the observation group was significantly higher than that in the control group (P<0.05). Regarding safety, the overall incidence of proteinuria and hypertension in the observation group during treatment was higher than that in the control group (P<0.05). Follow-up results showed that the control group had a PFS of 6.95±1.71 months with 28 deaths and an OS of 7.42±1.67 months; the observation group had a PFS of 8.26±2.34 months with 17 deaths and an OS of 10.63±1.92 months. Differences between the two groups were statistically significant (χ2=7.986, 8.012, P<0.05). After treatment, levels of CEA, CA125, Cyfra21-1, and IL-10 decreased in both groups, whereas IL-2 and IFN-γ increased compared with pre-treatment levels, with more pronounced changes observed in the observation group (P<0.05). Conclusion: The addition of anlotinib to TP chemotherapy significantly improves disease control, extends PFS and OS, and modulates tumor marker levels and inflammatory responses in advanced progressive NSCLC, suggesting a potential immunomodulatory role in the tumor microenvironment. However, anlotinib is associated with increased risks of proteinuria and hypertension, warranting careful monitoring and individualized management.

参考文献

 [1] 何璐,李志文,孟凡青,等. 非小细胞肺癌组织病理特征与临床预后、基因组突变谱的关联研究[J]. 临床与实验病理学杂志,2025,41(1):99-104.
     [2] 陈娟,梁龙,姚文秀. 晚期NSCLC患者外周血炎性标记物与EGFR-TKIs靶向治疗相关预后的关联及研究进展[J]. 肿瘤预防与治疗,2022,35(12):1117-1125.
     [3] 于凯伊,戴朝霞. 一代EGFR-TKI治疗后缓慢进展的晚期NSCLC患者原药维持联合阿帕替尼的疗效及安全性[J]. 现代肿瘤医学,2019,27(22):4001-4005.
     [4] 刘祺,周政涛,冯正富,等. 适形调强放射治疗同步TP化疗对局部晚期非小细胞肺癌患者免疫功能、全身炎症反应指标和血清肿瘤标志物的影响[J]. 现代生物医学进展,2021,21(17):3350-3354.
     [5] 马志敏,巨晓,降文豪,等. 补肺活血胶囊联合TP方案对晚期非小细胞肺癌临床疗效、T细胞亚群及相关细胞因子的影响[J]. 河北医药,2022,44(9):1350-1353.
     [6] 曹健,成怡楠,梁小红,等. 复肺方辅助TP方案治疗中晚期非小细胞肺癌患者的临床疗效及对其血清肿瘤标志物、生活质量的影响[J]. 世界中西医结合杂志,2023,18(1):173-178.
     [7] 童刚,华杨,彭薇,等. TACE联合安罗替尼及信迪利单抗治疗CNLCⅡb~Ⅲb期肝癌患者的疗效及安全性评估[J]. 中国癌症杂志,2025,35(5):478-484.
     [8] 甘钦,刘天龙,李国强. 纳武利尤单抗单药及联合安罗替尼治疗老年晚期胃癌患者的效果[J]. 中华老年多器官疾病杂志,2025,24(6):456-460.
     [9] 吴健,李培培,祝永福,等. 基于真实世界数据的安罗替尼三线治疗晚期非小细胞肺癌的临床评价[J]. 中国药房,2025,36(12):1488-1494.
     [10] 张旻,费霞,周新. 第8版国际肺癌TNM分期标准修订稿解读[J]. 世界临床药物,2016,37(7):441-445.
     [11] 张淑琴,唐华,王珊珊,等. 国标ICF-RS评估肿瘤患者功能状态的信效度研究[J]. 中国康复,2025,40(3):150-155.
     [12] 冯奉仪. 实体瘤新的疗效评价标准(解读1.1版RECIST标准)[C]. 第三届中国肿瘤内科大会论文集,2009:123-125.
     [13] 魏启明,钟胜,张海明,等. 仑伐替尼联合免疫检查点抑制剂二线治疗HAIC后进展性晚期肝细胞癌安全性和有效性[J]. 介入放射学杂志,2025,34(3):261-267.
     [14] Han B, Li K, Wang Q, et al. Effect of anlotinib as a third-line or further treatment on overall survival of patients with advanced non-small cell lung cancer: the ALTER 0303 phase 3 randomized clinical trial[J]. JAMA Oncol,2018,4(11):1569-1575.
     [15] 葛覃,沈健,赵荣. 安罗替尼联合PD-1抑制剂治疗晚期卵巢癌临床转归的影响因素及其预测效能[J]. 青岛大学学报(医学版),2025,61(3):406-410.
     [16] 杨玉梅,刘雪柔,刘伟,等. 阿美替尼联合安罗替尼通过下调PI3K/AKT通路抑制非小细胞肺癌细胞的增殖[J]. 南方医科大学学报,2024,44(10):1965-1975.
     [17] 张全,曹志坤,丁成智,等. 安罗替尼通过核因子信号通路抑制非小细胞肺癌细胞增殖、迁移和侵袭并促进细胞凋亡[J]. 中华实验外科杂志,2024,41(12):2778-2782.
     [18] 苏雨栋,赵强. 安罗替尼对MYCN扩增神经母细胞瘤增殖凋亡与迁移侵袭的影响及机制研究[J]. 中国肿瘤临床,2024,51(24):1250-1254.
     [19] 何广,冀东,宋翠萍,等. 肿瘤相关巨噬细胞内SHP-2过表达通过激活PI3K/mTOR通路加速血管新生促进乳腺癌进展的研究[J]. 中国肿瘤外科杂志,2025,17(3):291-298.
     [20] 曹赛雅,陈超,王杰. 肿瘤血管新生在肿瘤免疫治疗中的研究进展[J]. 肿瘤,2023,43(7):626-634.
     [21] 徐可佩,方晓政,林怡,等. MRI影像组学与乳腺癌肿瘤新生血管相关性研究[J]. 磁共振成像,2022,13(8):146-149.
     [22] 洪乔军,韩冬冬,方瑜,等. 免疫检查点抑制剂联合安罗替尼治疗晚期非小细胞肺癌的临床疗效[J]. 临床药物治疗杂志,2024,22(8):63-68.
     [23] 晏芾,滕悦,俞心念,等. 安罗替尼联合PD-1抑制剂二线治疗老年晚期肺腺癌患者的疗效及对T淋巴细胞亚群的影响[J]. 南京医科大学学报(自然科学版),2023,43(4):550-554.
     [24] 杨玉翠,徐玉良,肖李帅,等. 安罗替尼联合卡瑞利珠单抗对广泛期小细胞肺癌维持治疗的疗效与安全性观察[J]. 临床肺科杂志,2024,29(8):1200-1205.
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