Efficacy and Safety of Sintilimab Combined with Pemetrexed and Platinum Chemotherapy in Non-Small Cell Lung Cancer Patients.

ABSTRACT

Objective: This study aimed to evaluate the clinical efficacy and safety of siltuximab in combination with pemetrexed and platinum-based chemotherapeutic agents for treating non-small cell lung cancer (NSCLC) through a randomized trial. Methods: Ninety-two NSCLC patients admitted to our hospital between July 2020 and July 2022 were randomly assigned to receive either pemetrexed + platinum drugs (observation group) or sintilimab plus pemetrexed + platinum drugs (experimental group) in a 11 ratio. Outcome measures included clinical efficacy, safety, serum tumor marker levels (CA125, CEA, CA199), immune function (CD4+, CD8+, CD4+/CD8+), cell growth factors (VEGF, bFGF, MMP-9), and survival quality indices (KPS, FACT-L scale). Results: In the observation group, the objective remission rate (ORR) was 36.96%, and the disease control rate (DCR) was 76.09%. In the experimental group, the ORR was 63.04%, and the DCR was 91.30%. Sintilimab enhanced the clinical efficacy of pemetrexed + platinum drugs, as indicated by improved ORR and DCR in the observation group (P < .05). The incidence of toxic side effects was 39.13% in the observation group and 43.48% in the experimental group, showing no significant difference (P > .05). Sintilimab + pemetrexed + platinum drugs demonstrated marked anti-tumor efficacy, reducing serum CA125, CEA, and CA199 concentrations compared to the regimen without sintilimab (P < .05). Patients with sintilimab exhibited enhanced immune function, with significantly higher CD4+ and CD4+/CD8+ levels and lower CD8+ levels (P < .05). Sintilimab + pemetrexed + platinum drugs resulted in lower levels of VEGF, bFGF, and MMP-9 compared to pemetrexed + platinum drugs (P < .05), suggesting better cell growth. Sintilimab + pemetrexed + platinum drugs enriched the survival quality of patients, indicated by higher KPS and FACT-L levels (P < .05). Additionally, the demographic characteristics of patients, including age, gender distribution, and disease stage, were comparable between the two groups. Conclusion: The combination of sintilimab with pemetrexed + platinum-based chemotherapeutic agents shows therapeutic benefits in NSCLC. Improved ORR and DCR in the experimental group underscore clinical relevance. While promising, caution is needed due to the modest sample size and potential biases. A nuanced understanding of limitations is crucial for future research and application. This study prompts further research in NSCLC, advocating for larger cohorts and long-term follow-ups to explore sustained efficacy and potential biomarkers, guiding improvements in patient care.