Effects of PD-1 inhibitor combined with anti-angiogenic drugs on efficacy and immune function of non-small cell lung cancer

Objective: To investigate the effect of PD-1 inhibitor combined with anti-angiogenic drugs on the thera-peutic efficacy and immune function of patients with non-small cell lung cancer (NSCLC). Methods: Clinical data of 60 NSCLC patients who admitted to a regional Hospital of Traditional Chinese Medicine from May 2020 to August 2021 were analyzed retrospectively. Among them, 23 patients who received sintilimab and anlotinib were in group A, 20 patients treated with sintilimab were in group B, and 17 patients intervened by anlotinib alone were in group C. The changes of clinical efficacy, objective remission rate (ORR) and disease control rate (DCR) among the three groups were compared. The levels of cluster of differentiation 4 (CD4)(+), cluster of differentiation 8 (CD8)(+) and CD4(+)/ CD8(+) were assessed before and 6 weeks after treatment. The progression-free survival (PFS) was calculated and the prognostic factors were analyzed by Cox regression. The adverse reactions of immunotherapy in three groups were evaluated. Results: There was no obvious difference in ORR among the three groups (P > 0.05). The proportion of DCR in group A was dramatically higher than that in group B and C (P < 0.05). After treatment, the CD4(+) and CD4(+)/ CD8(+) levels were markedly higher, while the CD8+ level in group A was lower in group A than those in the other two groups (P < 0.05). There was no obvious difference in the incidence of immune-related adverse reactions among the three groups (P > 0.05). The median PFS of patients was 6.03 months. Cox regression analysis revealed that Eastern Cooperative Oncology Group score, tumor metastasis and treatment regimen were independent prognostic factors affecting PFS. Conclusion: Sintilimab combined with anlotinib can effectively improve DCR and prolong PFS in NSCLC patients, and this regimen does not increase immune-related adverse reactions during treatment.