Study On The Correlation Between The Efficacy Of Icaritin Combined With Conventional Regimen In The Treatment Of Advanced Malignant Solid Tumors

[Objective]:As a small molecule immunomodulatory drug extracted from traditional Chinese medicine epimedium,icaritin can act on many tumor proliferation signaling pathways such as IL-6/JAK2/STAT3,down-regulate the expression of PD-L1,regulate immunity and inhibit tumor growth.It has shown good anti-tumor effects in many tumor cell or animal experiments.The aim of this study is to explore the efficacy and safety of combination therapy of icaritin and conventional regimen in the treatment of advanced tumors.[Methods]:To evaluate the efficacy and safety of icaritin combined with conventional regimen in patients with advanced liver cancer,breast cancer and non-small cell lung cancer confirmed by clear histological or cytological examination from January 2017 to January 2019.At the same time,the correlation between the concentration of cytokines in peripheral blood before and after treatment was monitored to evaluate its correlation with efficacy and prognosis.Statistical analysis was performed using SPSS18.0 software.P<0.05 was considered statistically significant.[Results]:1.Forty-five eligible patients were included,including 17 cases of hepatocellular carcinoma,14 cases of breast cancer and 14 cases of non-small cell lung cancer.At the end of the last follow-up,15 of 17 patients in the hepatocellular carcinoma group had disease progression,and mPFS was 3.0 months.All 14 patients in the non-small cell lung cancer group had disease progression,mPFS was 5.0 months.Four of 14 patients in the breast cancer group had disease progression,and mPFS had not yet reached.In terms of safety,the types of adverse reactions were similar to those reported in routine regimens.There were fewer adverse reactions above grade III,and no adverse reactions related to icaritin were found.The safety tolerance was good.Because of the good curative effect observed in the non-small cell lung cancer group,19 patients with non-small cell lung cancer treated at the same time were retrospectively collected as the control group for survival and safety analysis.The results showed that there was no significant difference in baseline characteristics between the two groups(P>0.05).The mPFS of the observation group was 5 months,and that of the control group was 4 months.By log-rank analysis,the P FS of the observation group was significantly longer than that of the control group(P<0.05).There was no significant difference in the type and incidence of adverse reactions of grade III and above between the two groups.2.By monitoring the changes of cytokine concentration at three time points:screening stage,after the first cycle and the first evaluation,we found that:1)Except Eotaxin showed statistical difference(P<0.01),there was no significant difference in the other 11 cell factors among the three groups(P>0.05).2)The concentrations of IL-2,PDGF and IL-9 in hepatocellular carcinoma group and non-small cell lung cancer group increased gradually with statistical significance(P<0.05).3)In the immunotherapy group,the concentration of IL-2 was PD>PR+SD after the first cycle and at the first evaluation.The concentration of IL-9 was PR+SD>PD at the first evaluation.The concentration of IP-10 was PD>PR+SD after the first cycle and the concentration of PDGF was PD>PR+SD at the first evaluation.In the targeted therapy group,the concentration of FGF and TNF-a was PR+SD>PD at the screening stage.In the chemotherapy group,the concentration of IL-6 was PR+SD>PD after the first cycle,and the concentration of PDGF was PD>PR+SD at the first evaluation.The above changes had statistical significance(P<0.05).[Conclusion]:Icaritin combined with routine regimen has a certain potential efficacy in the treatment of malignant advanced solid tumors,and has good safety and tolerance.At the same time,the combination of icaritin and routine regimen can regulate the immune status of the body and promote the immune system to play an anti-tumor role.