ABSTRACT
Objective:To compare the efficacy and safety of programmed death-1 (PD-1) inhibitors monotherapy and combined with chemotherapy/targeted therapy in the treatment of advanced malignant tumors.Methods:The clinical data of 52 patients with advanced malignant tumors treated with PD-1 inhibitors from January 2017 to August 2018 in Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College were analyzed. All the patients were divided into monotherapy group ( n=23) and combined therapy group ( n=29) according to the therapeutic regimen. The monotherapy group received only PD-1 inhibitors and the combined therapy group received PD-1 inhibitors combined with chemotherapy/targeted therapy. The therapeutic effects and adverse reactions of the two groups were compared. Results:Of the 52 patients, 38 were evaluated according to the imaging results, including 15 in the monotherapy group and 23 in the combined therapy group. The overall response rates of the monotherapy group and combined therapy group were 33.33% (5/15) and 34.78% (8/23) respectively, with no significant difference ( P=0.604). The disease control rates of the monotherapy group and combined therapy group were 80.00% (12/15) and 73.91% (17/23), with no significant difference ( P=0.490). The median overall survival (OS) of the monotherapy group was 6.0 months, and that of the combined therapy group was 5.0 months, with no significant difference ( χ2=0.790, P=0.374). The median progression-free survival (PFS) of the monotherapy group was 6.0 months, and that of the combined therapy group was 5.0 months, with no significant difference ( χ2=0.371, P=0.542). The incidence of abdominal pain and diarrhea was lower in the monotherapy group [grade 1-2: 8.7% (2/23), grade 3 and above: 0] than that in the combined therapy group [grade 1-2: 27.59% (8/29), grade 3 and above: 6.90% (2/29); Z=2.211, P=0.027]. There were no significant differences in the incidence of bone marrow suppression, nausea and vomiting, rash, liver and kidney function impairment or treatment-related pneumonia between the two groups (all P>0.05). Conclusion:For patients with advanced malignant tumors, there is no significant difference in OS and PFS whether PD-1 inhibitors are taken separately or together, but the incidence of abdominal pain and diarrhea in patients treated with PD-1 inhibitors alone is lower than that in patients treated with combined therapy.
ABSTRACT
Objective@#To preliminarily compare the efficacy and safety of Pembrolizumab and Nivolumab in the treatment of advanced malignant tumors.@*Methods@#Clinical data of 50 patients diagnosed with advanced malignant tumors treated with Pembrolizumab and Nivolumab from January 2017 to August 2018 in our hospital were retrospectively analyzed. All patients were divided into the Pembrolizumab (n=26) and Nivolumab groups (n=24). The incidence of adverse reactions was statistically compared between two groups by using χ2 test. The survival analysis was performed by using Kaplan-Meier method.@*Results@#The median progression-free survival in the Pembrolizumab group was 213 d, and 146 d in the Nivolumab group (P>0.05). The incidence of aminotransferase elevation and hypothyroidism in the Nivolumab group was significantly higher than that in the Pembrolizumab group (63% vs. 23%, 12% vs. 0%, both P<0.05), whereas the incidence of oral mucositis in the Nivolumab group was 0%, significantly lower than 15% in the Pembrolizumab group (P<0.05). The median overall survival time in the Pembrolizumab group was 579 d, and 238 d in the Nivolumab group (P>0.05).@*Conclusion@#Clinical efficacy does not significantly differ, whereas the incidence of adverse reactions slightly differs between the Pembrolizumab and Nivolumab groups.
ABSTRACT
Objective To preliminarily compare the efficacy and safety of Pembrolizumab and Nivolumab in the treatment of advanced malignant tumors.Methods Clinical data of 50 patients diagnosed with advanced malignant tumors treated with Pembrolizumab and Nivolumab from January 2017 to August 2018 in our hospital were retrospectively analyzed.All patients were divided into the Pembrolizumab (n =26) and Nivolumab groups (n =24).The incidence of adverse reactions was statistically compared between two groups by using x2 test.The survival analysis was performed by using Kaplan-Meier method.Results The median progression-free survival in the Pembrolizumab group was 213 d,and 146 d in the Nivolumab group (P＞0.05).The incidence of aminotransferase elevation and hypothyroidism in the Nivolumab group was significantly higher than that in the Pembrolizumab group (63％ vs.23％,12％ vs.0％,both P＜0.05),whereas the incidence of oral mucositis in the Nivolumab group was 0％,significantly lower than 15％ in the Pembrolizumab group (P＜0.05).The median overall survival time in the Pembrolizumab group was 579 d,and 238 d in the Nivolumab group (P＞0.05).Conclusion Clinical efficacy does not significantly differ,whereas the incidence of adverse reactions slightly differs between the Pembrolizumab and Nivolumab groups.