Objective  To investigate the clinical efficacy and safety of the combination PP (Pemetrexed+Cisplatin) regimen of sindilizumab (Sintilimab)+bevacizumab (Bevacizumab) in advanced non-squamous non-small cell lung cancer (NSCLC) with disease progression after treatment with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors.

Methods  Patients with advanced non-squamous NSCLC with disease progression after receiving EGFR tyrosine kinase inhibitor treatment from January 2019 to January 2022 were retrospectively selected from The Third Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine. According to the different treatment modalities, patients were divided into the pemetrexed+cisplatin treatment group (Chemotherapy) group and the pemetrexed+cisplatin+sindilizumab+bevacizumab treatment (Sintilimab+Bevacizumab) group. Progression-free survival (PFS), overall survival (OS), objective response rate (ORR) and disease control rate (DCR) were compared between the two groups and the occurrence of adverse reactions was assessed.

Results  A total of 107 patients were enrolled in the study, 53 in the Sintilimab+Bevacizumab group and 54 in the Chemotherapy group. The median PFS and median OS were significantly higher in the Sintilimab+Bevacizumab group than in the Chemotherapy group (P<0.05). The median PFS and median OS in the Sintilimab+Bevacizumab group were significantly higher than in the Chemotherapy group. Bevacizumab group had no statistically significant difference in ORR with Chemotherapy group (P>0.05), while DCR was significantly higher than Chemotherapy group (P<0.05). The main adverse reactions were similar in both groups with the most common adverse events being anemia and neutrophils decrease.

Conclusion  Sintilimab+Bevacizumab combined with PP regimen treatment improved DCR and prolonged PFS and OS in patients with advanced non-squamous NSCLC whose disease progressed after EGFR tyrosine kinase inhibitor treatment.

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