国际肿瘤学杂志

国际肿瘤学杂志 ›› 2026, Vol. 53 ›› Issue (11): 681-687.doi: 10.3760/cma.j.cn371439-20260508-00106

• 论著 • 上一篇    下一篇

白蛋白结合型紫杉醇联合贝伐珠单抗治疗铂耐药复发卵巢癌的疗效及安全性​

张婷, 陈倩, 钱秋红()   

  1. 山东大学齐鲁医院妇产科， 济南 250012
  • 收稿日期:2026-05-08 出版日期:2026-11-08 发布日期:2026-11-05
  • 通讯作者: 钱秋红，Email： qianqiuhong99@sina.com
  • 作者简介:

    张婷：数据收集、整理，论文撰写；陈倩：统计学分析、论文撰写；钱秋红：研究指导、论文修改

  • 基金资助:
    2021年度山东省医学会临床科研资金—齐鲁专项(YXH2022ZX02146)

Efficacy and safety of nab-paclitaxel combined with bevacizumab in the treatment of platinum-resistant recurrent ovarian cancer

Zhang Ting, Chen Qian, Qian Qiuhong()   

  1. Department of Obstetrics and Gynecology， Qilu Hospital of Shandong University， Jinan 250012， China
  • Received:2026-05-08 Online:2026-11-08 Published:2026-11-05
  • Supported by:
    2021 Shandong Medical Association Clinical Research Fund—Qilu Special Project(YXH2022ZX02146)

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摘要：

目的 探讨白蛋白结合型紫杉醇联合贝伐珠单抗治疗铂耐药复发卵巢癌的有效性及安全性。 方法 纳入山东大学齐鲁医院2022年6月—2025年6月收治的铂耐药复发卵巢癌患者71例，均接受≥3个周期的白蛋白结合型紫杉醇+贝伐珠单抗联合化疗，对患者进行疗效和安全性评估。绘制Kaplan-Meier生存曲线进行生存分析并行log-rank检验。 结果 所有患者的治疗周期数为（5.63±1.37）个周期，客观缓解率（ORR）为50.70%（36/71），疾病控制率（DCR）为81.69%（58/71）。末次铂类化疗至复发时间≤3个月患者的DCR[72.97%（27/37）]显著低于复发时间>3个月且≤6个月的患者[91.18%（31/34）]（χ2=3.93，P=0.048）；治疗4周期后，糖类抗原125（CA125）下降≥50%患者的ORR为66.67%（30/45），DCR为91.11%（41/45），均高于CA125下降<50%患者的26.67%（4/15）、60.00%（9/15）（χ2=7.33，P=0.007；χ2=7.84，P=0.005）。既往未使用贝伐珠单抗的患者ORR[70.37%（19/27）]、DCR[96.3%（26/27）]均高于既往使用贝伐珠单抗患者的38.64%（17/44）、72.73%（32/44）（χ2=6.74，P=0.009；χ2=6.21，P=0.013）。生存分析显示，71例卵巢癌患者的中位无进展生存期（PFS）为7.0个月；末次铂类化疗至复发时间为>3个月且≤6个月患者的中位PFS（9.0个月）较≤3个月患者（6.0个月）有延长趋势，但差异无统计学意义（χ2=3.82，P=0.051）。患者出现的主要不良反应为神经毒性[57.75%（41/71）、蛋白尿[46.48%（33/71）]和恶心呕吐[（46.48%，33/71）]，均以1~2级为主，3~4级不良反应主要为中性粒细胞减少[15.49%（11/71）]。 结论 白蛋白结合型紫杉醇联合贝伐珠单抗治疗铂耐药复发卵巢癌疗效确切，耐受性良好。

关键词: 卵巢肿瘤, 复发, 白蛋白结合型紫杉醇, 贝伐珠单抗, 无进展生存期

Abstract:

Objective To investigate the efficacy and safety of nab-paclitaxel combined with bevacizumab in the treatment of platinum-resistant recurrent ovarian cancer. Methods A total of 71 patients with platinum-resistant recurrent ovarian cancer admitted to Qilu Hospital of Shandong University from June 2022 to June 2025 were enrolled. All patients received ≥3 cycles of nab-paclitaxel combined with bevacizumab. Efficacy and safety were evaluated after treatment. Survival outcomes were estimated using the Kaplan-Meier method and compared via log-rank tests. Results The mean number of treatment cycles of 5.63±1.37. The ORR was 50.70%（36/71）. The DCR was 81.69% （58/71）. The DCR in patients with time interval from last platinum-based chemotherapy to recurrence ≤3 months was significantly lower than that in patients with a time interval of >3 months and ≤6 months [72.97% （27/37） vs. 91.18% （31/34）； χ2=3.93， P=0.048]. After 4 cycles of treatment， patients with a carbohydrate antigen 125 （CA125） decrease of ≥50% had an ORR of 66.67% （30/45） and a DCR of 91.11% （41/45）， both higher than those with a decrease of <50% [26.67% （4/15） and 60.00% （9/15）， respectively； χ2=7.33， P=0.007； χ2=7.84， P=0.005]. Patients without prior bevacizumab treatment had higher ORR [70.37% （19/27）] and DCR [96.3% （26/27）] than those who had previously received bevacizumab [38.64% （17/44） and 72.73% （32/44）， respectively； χ2=6.74， P=0.009； χ2=6.21， P=0.013]. Survival analysis showed that the median progression-free survival （PFS） of the 71 patients was 7.0 months. The median PFS for patients with a time from last platinum-based chemotherapy to recurrence of > 3 months and ≤ 6 months （9.0 months） showed a trend of prolongation compared to those with ≤ 3 months （6.0 months）， but there was no statistically significant difference （χ2=3.82， P=0.051）.The most common adverse events were neurotoxicity [57.75% （41/71）]， proteinuria [46.48% （33/71）]， and nausea/vomiting [46.48% （33/71）]， predominantly grade 1-2. The main grade 3-4 adverse reaction was neutropenia [15.49% （11/71）]. Conclusions Nab-paclitaxel combined with bevacizumab shows promising efficacy and good tolerability in the treatment of platinum-resistant recurrent ovarian cancer.

Key words: Ovarian neoplasms, Recurrence, Albumin-bound paclitaxel, Bevacizumab, Progression-free survival