Efficacy of combined PD-1 immune therapy and chemotherapy in the treatment of locally advanced nonsmall cell lung cancer

Abstract

Purpose: To investigate the clinical efficacy of anti-programmed cell death-1 (PD-1) immunotherapy in combination with chemotherapy in patients  suffering from locally advanced non-small cell lung cancer (NSCLC). Methods: A total of 110 NSCLC patients admitted in The Second Affiliated Hospital of Hainan Medical University, Haikou, China were randomly divided  into two groups using envelope method. The control group was administered pemetrexed and cisplatin, and the study group was further treated with nivolumab. Each treatment cycle lasted for 21 days, and a total of 6 cycles were administered for the duration of therapy. The short-term objective  response rate, adverse reactions, programmed cell death5 (PDCD-5), tumor necrosis factor-α (TNF-α), tumor necrosis factor-β1 (TGF-β1), and immune  status indices were determined. Results: The objective remission rate in study group was 79.25 % (42/53), which was higher than that in control group (61.40 %, 35/57; p < 0.05). After  treatment, both groups showed higher levels of PDCD5 and TNF-α compared to their pre-treatment values, while demonstrating lower levels of TGF-β1. Furthermore, PDCD-5 and TNF-α in study group were higher than those in control group, while TGF-β1 was lower than that in control group (p < 0.05). In  control group, the values of clusters of differentiation 3+(CD3+), 4+(CD4+), and 8+(CD8+) decreased after treatment, while the values of CD8+ increased after treatment. The CD3+, CD4+, and CD4+/CD8+ in study group were higher than those in control group, while CD8+ was lower than those in control  group (p < 0.05). Conclusion: Anti-PD-1 immunotherapy combination with chemotherapy in the treatment of local NSCLC stabilizes the immune system  and improves the short-term efficacy of patients with advanced NSCLC. Further clinical trials are, however, required prior to application of this  combination clinical practice.