Abstract

This study aims to investigate the short- and long-term therapeutic efficacy, as well as the safety profile, of combined treatment with atezolizumab and bevacizumab in patients diagnosed with non-squamous non-small cell lung cancer (NS-NSCLC) characterized by elevated expression of programmed death ligand-1 (PD-L1). Over the period spanning from June 2019 to June 2022, Jinhua Municipal Central Hospitall enrolled 100 patients diagnosed with NS-NSCLC exhibiting PD-L1 overexpression. Among them, 50 individuals were allocated to the observation group and another 50 to the control group as per the treatment strategy they received. The control group was subjected solely to bevacizumab treatment, while the observation group received a combination therapy of atezolizumab along with bevacizumab. Each group underwent therapy administered in cycles spanning 21 days, with a cumulative duration of three cycles. The investigation entailed a juxtaposition of clinical effectiveness, the incidence of unfavorable responses, and one-year survival proportion amid the two cohorts. Moreover, a comparison was conducted concerning alterations in the levels of immunoglobulin G (IgG), immunoglobulin M (IgM), immunoglobulin A (IgA), carcinoembryonic antigen (CEA), vascular endothelial growth factor (VEGF), and carbohydrate antigen 125 (CA125) before and after treatment in both groups. The cumulative response proportion in the observation group (74.00%) surpassed that in the control group (54.00%) with a statistically significant differentiation (P<0.05). Following treatment, IgA, IgG, and IgM levels in the observation group demonstrated conspicuous elevations compared to the pre-treatment levels and the post-treatment levels in the control group, exhibiting statistically significant differences (P<0.05). In addition, the levels of CEA, VEGF, and CA125 in the observation group after treatment showed a substantial decrease compared to their pre-treatment levels and the post-treatment levels in the control group, with disparities holding statistical significance (P<0.05). Nevertheless, despite a slightly higher overall incidence of adverse reactions in the observation group (38.00%) compared to the control group (30.00%), the variance was insignificant (P>0.05). Throughout the course of the one-year follow-up, no instances of follow-up attrition were recorded. The observation group had a mortality rate of 36.00% (18/50) and a one-year survival rate of 64.00% (32/50), whereas the control group exhibited a mortality rate of 40.00% (20/50) and a one-year survival rate of 60.00% (30/50). Kaplan-Meier survival analysis did not reveal any considerable divergence in survival rates between the two groups (Log-Rank=0.018, P=0.893). The combination therapy of atezolizumab and bevacizumab demonstrated favorable outcomes in patients with PD-L1 overexpressing NS-NSCLC, leading to effective enhancement of patient immune function and modulation of CEA, VEGF, and CA125 levels. Furthermore, the treatment exhibited good patient tolerability, thereby warranting attention from clinical practitioners.