Abstract: Objective The aim of this study was to investigate the clinical comparative analysis of anti-angiogenic drugs combined with programmed cell death 1(PD-1)inhibitor and chemotherapy in the second-line treatment of advanced lung adenocarcinoma.Methods A retrospective analysis of 99 patients with advanced lung adenocarcinoma admitted to The First Affiliated Hospital of Hebei North University from January 1,2017 to December 31,2020 was performed.They were divided into the simple chemotherapy group(n=35),chemotherapy combining with anti-angiogenic drugs group(n=34),and chemotherapy combined with anti-angiogenic drugs and immunotherapy group(n=30).The clinical efficacy and adverse reactions of the three groups were compared.Results The disease control rate(DCR)of the three groups were 48.6%,55.9% and 80.0%,respectively,and the difference was statistically significant(P=0.028).The Objective response rate(ORR)was 11.4%,8.8% and 23.3%,respectively,and the difference was not statistically significant(P=0.273).The median progression-free survival(PFS)of the three groups were 2.4 months,4.3 months and 6.2 months,respectively,and the difference was statistically significant(P＜0.001).During the treatment,the most common adverse reactions in the three groups were leukopenia,nausea and vomiting,elevated transaminases and fatigue,etc.and most of them were grade 1-2.Univariate analysis showed that clinical stage was an independent factor affecting PFS.Multivariate Cox regression analysis showed that brain metastasis was an independent prognostic factor of PFS after considering grouping factors.Conclusion The comparative analysis of the three groups showed that the second-line application of PD-1 inhibitor combined with anti-angiogenic drugs and chemotherapy in the treatment of advanced lung adenocarcinoma was effective and safe.

Key words: Lung adenocarcinoma, Anti-angiogenesis therapy, Programmed cell death 1 inhibitor, Short-term efficacy, Safety