Efficacy of Careolizumab combined with chemotherapy and astragalus polysaccharide(APS) in patients with intermediate to advanced NSCLC and effects on lymphocyte subsets, regulatory T cells and serum tumor markers

Abstract

Abstract Objctive:To observe the recent efficacy of the combination group on patients with intermediate to advanced non-small cell lung cancer (NSCLC) and the effects on lymphocyte subsets, regulatory T cells, serum cytokeratin 19 fragment (CYFRA21-1), angiopoietin-2 (Ang-2), and vascular endothelial growth factor (VEGF). Methods:188 patients with intermediate to advanced NSCLC admitted to our hospital from August 2021 to April 2023 were selected, and the patients were simply randomly divided into a combination group and a control group. The control group was treated with chemotherapy regimen, and the combination group was treated with Carelizumab and astragalus polysaccharide on top of it. The recent efficacy, lymphocyte subsets (B, NK, CD3+,CD4+, CD4+/CD8+), regulatory T cells (CD4+Treg) , serum tumor markers CYFRA21-1, carcinoembryonic antigen (CEA), tumor antigen 125 (CA125), neurospecific enolase (NSE)] and angiogenic indexes (Ang-2, VEGF). Results:The total effective rate of recent clinical efficacy in the combined group after treatment was 69.15%, which was significantly higher than that in the control group (38.3%) (P<0.05). After treatment, the levels of B, NK, CD3+, CD4+ and CD4+/CD8+ were reduced in both groups, and the levels in the combined group were higher than those in the control group (P<0.05); the levels of CYFRA21-1, CEA, CA125 and NSE were reduced in both groups, and the levels in the combined group were significantly lower than those in the control group (P<0.05); the levels of Ang-2 and The levels of Ang-2 and VEGF were reduced in both groups, and the levels of Ang-2 and VEGF in the combined group were significantly lower than those in the control group (P<0.05). Progression-free survival was higher in the combination group than in the control group (95% CI, 1.468-4.278; Log-rank P < 0.0001; HR, 2.506). Conclusion: Carelizumab combined with chemotherapy and astragalus polysaccharide has definite near-term efficacy in patients with intermediate to advanced NSCLC, and can reduce the impact on immune function, prolong patients' progression-free survival, significantly improve serum tumor marker levels and play a certain inhibitory effect on angiogenesis.