Abstract:

Objective To explore the efficacy of atezolizumab combined with anlotinib in treating advanced non-small cell lung cancer （NSCLC）. Methods A total of 80 patients with advanced NSCLC treated in the Baoding No.2 Central Hospital from September 2019 to September 2023 after second-line treatment were selected as research subjects. Patients who received only anlotinib treatment were included in the monotherapy group （n=40）， while patients who received atezolizumab combined with anlotinib treatment were included in the combination group （n=40）. The clinical efficacy and serum levels of carcinoembryonic antigen （CEA） and vascular endothelial growth factor （VEGF） of the two groups were compared. Kaplan-Meier survival curve was used to analyze the survival of the two groups. The functional assessment of cancer therapy-lung cancer （FACT-L） was used to assess the quality of life of patients in both groups before and after treatment. The incidence of adverse reactions was compared between the two groups. Results After four cycles of treatment， the objective response rate （ORR） of the combination group was 37.50% （15/40）， which was higher than that of the monotherapy group [17.50% （7/40）]， with a statistically significant difference （χ²=4.01， P=0.045）. The disease control rates （DCRs） of the two groups were 85.00% （34/40） and 75.00% （30/40）， respectively， with no statistically significant difference （χ²=1.25， P=0.264）. Before treatment， the CEA levels in combination group and monotherapy group were （10.18±2.15） and （10.14±2.02） μg/L， and the VEGF levels were （804.04±46.58） and （809.10±43.63） ng/L， respectively， with no statistically significant difference （both P>0.05）. After treatment， the serum CEA levels of patients in combination group and monotherapy group were （4.35±1.05） and （6.63±1.37） μg/L， and the VEGF levels were （431.26±50.19） and （549.92±55.27） ng/L， respectively， with statistically significant differences （t=8.35， P<0.001； t=10.05， P<0.001）， and the levels of serum CEA and VEGF in the two groups after treatment were lower than before treatment （t=32.47， P<0.001； t=21.73， P<0.001； t=88.65， P<0.001； t=58.27， P<0.001）. Survival analysis showed that the median progression-free survival （PFS） of the monotherapy group and the combination group were 4.12 and 6.06 months， respectively， with a statistically significant difference （χ²=17.70， P<0.001）， the median overall survival （OS） were 11.8 and 12.7 months， respectively， with no statistically significant difference （χ²=3.09， P=0.079）. Before treatment， the FACT-L scores of patients in combination group and monotherapy group were 61.20±6.98 and 60.52±7.14， respectively， with no statistically significant difference （t=0.43， P=0.668）. After treatment， the FACT-L scores of the two groups were 83.24±9.38 and 74.58±7.86， respectively， with a statistically significant difference （t=4.48， P<0.001）， and the FACT-L scores of the two groups after treatment were all higher than before treatment （t=29.36， P<0.001； t=21.51， P<0.001）. During treatment， the total incidence of drug-related adverse reactions in two groups was 42.50% （17/40） and 55.00% （22/40）， respectively， with no statistically significant difference （χ²=1.25， P=0.263）. Conclusions Atezolizumab combined with anlotinib in the treatment of advanced NSCLC can enhance the short-term efficacy， prolong the PFS of patients， improve the quality of life， and the related adverse reactions are tolerable.

Key words: Carcinoma， non-small-cell lung, Atezolizumab, Anlotinib, Treatment outcome