Clinical Study Of Endostar Combined With Pemetrexed Plus Cisplatin In Treating Patients With Stageof ?b/?EGFR Wild-type Nonsquamous Non-small Cell Lung Cancer

Objective:A randomized,controlled,open clinical trial was conductedto evaluate the clinical efficacy and safety of Endostar combined with pemetrexed plus cisplatin in the treatment of IIIB/IV epidermal growth factor receptor wild-type nonsquamous non-small cell lung cancer.Methods:This study collected 65 primary patients with stage IIIB/ IV EGFR wild-type non-squamous non-small cell lung cancer that met the inclusion criteria confirmed by the cytology or histopathology of the people,shospital of guangxi zhuang autonmous region between May 2015 and September 2017(31 patients in Endostar group and 34 in control group),patients in the Endo group received pemetrexed plus cisplatin combination with endostar in induction therapy,Subjects with unprogressed disease were treated with pemetrexed plus Endo maintenance until disease progression,while those in the control group were treated with pemetrexed plus cisplatin and Patients with unprogressed disease after platinum-induced chemotherapy undergo pemetrexed maintenance therapy.Observe progression-free survival(PFS),objective response rate(ORR),overall survival(OS)and adverse reactions in two groups of patients.Results: In this study,65 patients with stage IIIB/IV EGFR wild-type non-squamous non-small cell lung cancer were enrolled,31 in the Endo group and 34 in the control group,all patients had measurable lesions.Two groups of subjects received four cycles of induction therapy,and 3 patients in the Endo group developed disease progression,while 6 patients in the control group developed PD.Therefore,56 patients actually received enrollment,and 28 patients in the Endo group,28 in patients the control group.There was no significant difference in age,gender,smoking status,tumor stage,pre-treatment physical fitness score(ECOG score)between the two groups,and there was no statistical significance(P>0.05).Median progression-free survival(m PFS)in Endo group and control group was 9.5 months and 6.9 months,respectively,with statistical significance(P<0.05);ORR was 42.9% and 17.9(P=0.042),the best ORR in the two groups was 67.9% and 35.7%(P=0.031);follow-up to December 31,2017,median survival time(m OS)in Endo group and control group was 14.8 months and 12.2 months,although the median survival time compared with the control group was extended 2.6 months,but the difference between the two groups was not statistically significant(P = 0.326).There was no significant difference in the incidence of hematological toxicity,liver and kidney damage,gastrointestinal tract reaction,fatigue,and electrocardiogram changes between the Endo group and the control group(P>0.05).Conclusions:Endostar combined with pemetrexed plus cisplatin induction therapy and Endo combined with pemetrexed maintenance treatment prolonged the progression-free survival of patients with advanced nonsquamous NSCLC,increased the objective remission rate,and the adverse reactions were tolerable and safe.