Observation on the efficacy and safety of gemcitabine or paclitaxel for injection(albumin bound)combined with other drugs in the first-line treatment of advanced non-small cell lung cancer without gene mutation

Wang Guoping; Zhang Yan; Zeng Shouqiong

doi:10.3760/j.issn.1673-4777.2024.08.010

Abstract：Objective To observe the efficacy and safety of gemcitabine or paclitaxel for injection(albumin bound)combined with lobaplatin and camrelizumab as first-line treatment for advanced non-small cell lung cancer(NSCLC)without gene mutation.Methods Totally 120 patients with advanced NSCLC without gene mutation admitted to Chengdu Fifth People's Hospital,Sichuan Province from January 2022 to June 2023 were selected.They were divided into control group and observation group using a random number table method,with 60 cases in each group.The control group was treated with gemcitabine combined with lobaplatin and camrelizumab.The observation group was treated with paclitaxel for injection(albumin bound)combined with lobaplatin and camrelizumab.The levels of serum squamous cell carcinoma associated antigen(SCC),cytokeratin 19 fragment antigen(CA21-1),transforming growth factor-β,(TGF-β1),serum CD3+,CD4+,CD8+and the ratio of CD4+/CD8+were compared between the two groups before and 14 d after treatment.The clinical efficacy and incidence of toxic side effects were compared between the two groups.Results After 14 d of treatment,the levels of SCC,CA21-1 and TGF-β1and CD8+in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group;the serum levels of CD3+,CD4+,and the ratio of CD4+/CD8+in both groups were higher than those before treatment,and those in the observation group were higher than those in the control group(all P＜0.05).The objective remission rate and disease control rate of the observation group were higher than those of the control group[45.0％(27/60)vs 28.3％(17/60),73.3％(44/60)vs 58.3％(35/60)](both P＜0.05).The incidences of granulocytopenia and thrombocytopenia in the observation group were lower than those in the control group,and the incidence of muscle/joint pain was higher than that in the control group[25.0％(15/60)vs 78.3％(47/60),30.0％(18/60)vs 66.7％(40/60),71.7％(43/60)vs 23.3％(14/60)](all P＜0.05),and there was no statistically significant difference in the incidence of nausea and vomiting between the two groups(P＞0.05).Conclusions Compared with gemcitabine combined with lobaplatin and camrelizumab,paclitaxel for injection(albumin bound)combined with lobaplatin and camrelizumab is more effective in the first-line treatment of advanced NSCLC without gene mutations,which can effectively reduce the level of tumor markers.It also has the advantages of low toxicity,little effect on the immune system,helping the recovery of T lymphocyte subsets,and reducing bone marrow suppression.