Effect of PD-1/PD-L1 immunotherapy combined with AP regimen on inflammatory cytokines and immune function in patients with advanced lung adenocarcinomas

SHI Ying; MIAO Enping; WANG Qian

doi:10.3969/j.issn.1002-7386.2025.03.015

Abstract：Objective To investigate the effects of Sintilimab(PD-1/PD-L1)immunotherapy combined with pemetrexed+cisplatin(AP)regimen on inflammatory cytokines and immune function in patients with advanced lung adenocarcinomas.Methods A retrospective analysis was conducted on 80 patients with advanced lung adenocarcinomas admitted to our hospital from February 2019 to February 2022.Clinical data of the patients were collected.They were divided into the control group(AP regimen treatment,40 cases)and observation group(AP regimen+PD-1/PD-L1 treatment,40 cases)based on different chemotherapy regimens.A total of 6 courses,with 3 weeks per cycle were given.The efficacy of the two groups was compared.The levels of tumor markers(carbohydrate anti-125[CA125],carcinoembryonic antigen[CEA]),immune function indexes and inflammatory factors(C-reactive protein[CRP],tumor necrosis factor-α[TNF-α],interleukin-6[IL-6])were compared before and after 6 courses of treatment.The incidence of adverse events during treatment was compared between the two groups,and the survival of patients was followed up for 1 year.Results After 6 courses of treatment,the remission rate in the control group was significantly lower than that in the observation group(P＜0.05).After 6 courses of treatment,the levels of CA125 and CEA in the control group were significantly higher than those in the observation group(P＜0.05).After 6 courses of treatment,the levels of CD4 and CD3 in the control group were significantly lower than those in the observation group(P＜0.05).After 6 courses of treatment,serum TNF-α,CRP and IL-6 in the control group were significantly higher than those in the observation group(P＜0.05).During the treatment period,there was no significant difference in the incidence of adverse events between the two groups(P＞0.05).During the follow-up period,according to the Log Rank test,the overall survival rate determined by the log-rank test was significantly higher in the observation group than that of the control group(x2=9.608,P=0.002).Patients in the observation group had a significantly longer progression-free survival compared to the control group(t=3.141,P=0.002).Conclusion PD-1/PD-L1 immunotherapy combined with AP regimen has a significant therapeutic effect on patients with advanced lung adenocarcinomas.It can reduce tumor markers and inflammatory factors,improve immune function,and prolong the survival without increasing adverse events.