派安普利单抗联合培美曲塞及顺铂治疗转移性或局部晚期NSCLC的疗效研究及PD-1/PD-L1通路的调控作用<sup>★</sup>

doi:10.3969/j.issn.2095-1264.2025.04.13

首页 > 过刊浏览>2025年第4期 >530-535. DOI:10.3969/j.issn.2095-1264.2025.04.13

派安普利单抗联合培美曲塞及顺铂治疗转移性或局部晚期NSCLC的疗效研究及PD-1/PD-L1通路的调控作用★
DOI:
                        10.3969/j.issn.2095-1264.2025.04.13
                    
作者:
                        
                        
                    
作者单位:邢台医学高等专科学校第二附属医院 放化疗科，河北 邢台，054000
作者简介:武永存，硕士，副主任医师，研究方向为肺癌。
通讯作者:霍俊杰，硕士，副主任医师，研究方向为恶性肿瘤综合治疗。
中图分类号:R734.2;R730.51
基金项目:邢台市科技局重点研发计划项目（2021ZC172）。

Efficacy of penpulimab combined with pemetrexed and cisplatin in the treatment of metastatic or locally advanced NSCLC and its regulatory effect on the PD-1/PD-L1 pathway^★

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Affiliation:

Department of Chemoradiotherapy, The Second Affiliated Hospital of Xingtai Medical College, Xingtai, 054000, Hebei, China

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摘要:

目的探讨派安普利单抗联合培美曲塞及顺铂治疗转移性或局部晚期非小细胞肺癌（NSCLC）的疗效以及PD-1/PD-L1通路的调控作用。方法纳入2021年8月—2022年6月我院收治的NSCLC患者180例，随机分为观察组90例（派安普利单抗联合培美曲塞+顺铂）与对照组90例（培美曲塞+顺铂）。分析两组患者的治疗效果，并探讨PD-1/PD-L1通路的调控作用。结果观察组疾病控制率显著高于对照组（72.22% vs. 53.33%， χ²=6.871， P<0.05）；治疗前两组患者KPS评分无明显差异（P>0.05），治疗后两组患者KPS评分均显著增加（P<0.001），且观察组明显高于对照组（P<0.001）；治疗前两组患者CA125、CEA、NSE、CYFRA21-l水平无明显差异（P>0.05），治疗后两组患者上述指标均显著下降（P<0.001），且观察组显著低于对照组（P<0.001）；治疗前两组患者CD3+、CD4+ T淋巴细胞水平无明显差异（P>0.05），治疗后观察组CD3+、CD4+ T淋巴细胞水平显著升高，且高于对照组（P<0.001）；治疗后两组患者毒副作用发生率无明显差异（P>0.05）；治疗前两组患者sPD-1、sPD-L1水平无明显差异（P>0.05），治疗后两组患者上述指标水平均显著下降（P<0.0，01），且观察组显著低于对照组（P<0.001）。结论派安普利单抗联合培美曲塞及顺铂治疗转移性或局部晚期NSCLC疗效显著，可改善患者生存质量，提高其免疫功能，其作用机制可能是通过特异性阻断PD-1/PD-L1通路降低肿瘤细胞免疫逃逸并促进肿瘤细胞凋亡。

Abstract:

Objective To evaluate the efficacy of penpulimab combined with pemetrexed and cisplatin in the treatment of metastatic or locally advanced non-small cell lung cancer (NSCLC) and to explore its regulatory effect on the PD-1/PD-L1 pathway.Methods A total of 180 NSCLC patients admitted to our hospital between August 2021 and June 2022 were enrolled and randomly assigned to either the observation group (n=90, penpulimab plus pemetrexed and cisplatin) or the control group (n=90, pemetrexed and cisplatin). Treatment outcomes were analyzed, and the regulatory role on the PD-1/PD-L1 pathway was investigated.Results The disease control rate was significantly higher in the observation group than in the control group (72.22% vs. 53.33%, χ²=6.871, P<0.05). Before treatment, there was no significant difference in KPS scores between the two groups (P>0.05). After treatment, KPS scores increased significantly in both groups (P<0.001), and were significantly higher in the observation group than in the control group (P<0.001). Pretreatment levels of tumor markers (CA125, CEA, NSE, CYFRA21-1) showed no significant difference between groups (P>0.05). After treatment, these levels decreased significantly in both groups (P<0.001), with the observation group showing significantly lower levels than the control group (P<0.001). No significant difference was found in pretreatment levels of CD3+ and CD4+ T lymphocytes (P>0.05). But after treatment, the observation group exhibited significantly increased CD3+ and CD4+ T lymphocyte levels, which were higher than those in the control group (P<0.001). There was no significant difference in the incidence of toxic side effects between the two groups after treatment (P>0.05). Pretreatment levels of soluble PD-1 (sPD-1) and soluble PD-L1 (sPD-L1) were comparable between groups (P>0.05). After treatment, these levels decreased significantly in both groups (P<0.001), with the observation group showing significantly lower levels than the control group (P<0.001).Conclusion Penpulimab combined with pemetrexed and cisplatin demonstrates significant efficacy in treating metastatic or locally advanced NSCLC. It improves patients' quality of life and enhances immune function. The mechanism of action may involve specifically blocking the PD-1/PD-L1 pathway, thereby reducing tumor cell immune escape and promoting tumor cell apoptosis.