Analysis Of The Efficacy And Safety Of PD-1 Monoclonal Antibody In The Treatment Of Lung Malignant Tumors

Objective:To retrospectively analyze the efficacy of programmed cell death 1(PD-1)monoclonal antibody in the treatment of pulmonary malignant tumors;to observe the safety of PD-1 monoclonal antibody in the treatment of pulmonary malignant tumors;and to explore the predictive effect of adverse events on the efficacy.Methods: The data of patients with pulmonary malignant tumors who visited the Department of Oncology of the First Affiliated Hospital of China Medical University from April 2016 to April 2019 were retrospectively collected.The treatment cycle and adverse events after treatment were collected.The short-term efficacy and long-term efficacy were collected.The predictive effect of adverse events on the efficacy was explored.Results: A total of 56 patients with pulmonary malignant tumors were included in the study.The treatment cycles for single drug therapy and combination drug therapy were 9 cycles and 7 cycles in the first line of treatment,3 cycles and 2 cycles in the second line of treatment,respectively,and both 3 cycles in the third line of treatment.The objective response rate(ORR)was 32.14%,the disease control rate(DCR)was 64.29%,and the median progression-free survival(mPFS)was 4.2 months.The ORR was 64.71%,16.67%,and 11.11%;DCR was 100%,50%,and 44.44%;and mPFS was 6.6 months,2.1 months,and 1.9 months in patients with first line,second-line and third-line or above of treatment,respectively.The ORR was 45.67% and 15.38%(P = 0.02);DCR was 80% and 46.15%(P = 0.02)in patients who smoked or not,and the differences were statistically significant.mPFS was 6.2 months and 2.1 months,respectively,and there was no significant difference(P = 0.14).Comparative analysis between the single drug group and the combination drug group revealed that the ORR was 21.62% and 52.63%(P = 0.02);the DCR was 51.35% and 89.47%(P = 0.01),and the differences were statistically significant.The mPFS was 4.1 months and 6.2 months,respectively,and the differences were not statistically significant(P = 0.55).The overall incidence of adverse events(AE)was 75%,of which the incidence of grade 3-5 AE was 16.07%.Immune-related adverse events(irAE)were immune-related endocrine diseases,hepatotoxicity,hematology-related toxicity,and immune-related pneumonia,which occurred at 6 weeks,2.9 weeks,4.6 weeks,and 17.9 weeks,respectively.The common AEs in the combination drug group were hematology-related toxicity,immune-related skin toxicity,and gastrointestinal toxicity,which occurred at 5 weeks,3 weeks,and 5.2 weeks,respectively.Analysis of the relationship between AEs and efficacy revealed that patients who experienced immune-related pneumonia had a statistically significant longer mPFS than those who did not experience this AE(P = 0.02).Conclusion: PD-1 monoclonal antibody has certain efficacy and good safety in the treatment of pulmonary malignant tumors,and patients present with grade 1-2 adverse events mostly.Combination therapy and smoking may be more effective in patients,and the development of immune-related pneumonia may improve patient survival.