Objective:To investigate the clinical efficacy of osimertinib combined with tislelizumab in the treatment of advanced non-small cell lung cancer (NSCLC) and the survival status of patients.Methods:A total of 108 patients with advanced NSCLC in Suqian Hospital of Nanjing Drum Tower Hospital Group from February 2019 to January 2022 were prospectively selected, and they were divided into osimertinib combined with tislelizumab treatment group (study group) and osimertinib treatment group (control group) by random number table method, with 54 cases in each group. Three weeks were 1 cycle. The curative effect was observed after 3 cycles of treatment in both groups. The clinical efficacy, levels of tumor markers, immune function and adverse reactions were compared between the two groups. After 1 year of follow-up, the overall survival (OS) and progression-free survival (PFS) of the two groups were analyzed by Kaplan-Meier method and compared by log-rank test.Results:After 3 cycles of treatment, the disease control rate of the study group was higher than that of the control group [81.48% (44/54) vs. 59.26% (32/54), χ2 = 6.40, P = 0.011], and the objective remission rate of the study group was higher than that of the control group [57.41% (31/54) vs. 37.04% (20/54), χ2 = 4.50, P = 0.034]. Before treatment, the differences in the levels of cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), squamous cell carcinoma antigen (SCC-Ag) and tissue polypeptide antigen (TPA) between the two groups were not statistically significant (all P > 0.05), and after treatment, the levels of tumor markers were lower than those before treatment in both groups (all P < 0.05), and they were lower in the study group than those in the control group (all P < 0.05). Before treatment, there were no statistically significant differences in the proportions of CD3 + T cells, CD4 + T cells and CD8 + T cells between the two groups (all P > 0.05), and after treatment, the proportions of CD3 + T cells and CD4 + T cells were higher than those before treatment in both groups (both P < 0.05), and they were higher in the study group than those in the control group (both P < 0.001), and the proportion of CD8 + T cells before treatment in both groups was lower than that after treatment ( P < 0.05), and it was lower in the study group than that in the control group ( P < 0.001). The differences in the incidence of neutropenia, leukopenia, immune-associated pneumonia, and liver function injury between the two groups were not statistically significant (all P > 0.05). At 1 year of follow-up, there was 1 case of loss of follow-up in the study group and 2 cases of loss of follow-up in the control group, with a follow-up rate of 97.22% (105/108); there were 9 deaths in the study group with an OS rate of 83.02% and 20 deaths in the control group with an OS rate of 61.54%. OS and PFS in the study group were better than those in the control group [median OS time: 11 months (95% CI 6-11 months) vs. 8 months (95% CI 3-11 months), χ2 = 12.32, P < 0.001; median PFS time: 9 months (95% CI 4-11 months) vs. 5 months (95% CI 4-11 months), χ2 = 6.84, P < 0.001]. Conclusions:Osimertinib combined with tislelizumab can reduce the level of tumor markers and improve immune function in patients with advanced NSCLC with good short-term efficacy, and it doesn't increase the adverse effects and can result in a survival benefit.

A 59-year-old male patient received SOX chemotherapy regimen (IV infusion of oxaliplatin injection 200 mg dissolved in 5% glucose injection 250 ml for 2 hours on the first day, oral tegafur, gimeracil and oteracil potassium 60 mg once daily on day 1-14, every 3 weeks was a cycle) for gastric cancer with multiple lymph nodes metastases. One week after the infusion of oxaliplatin during the third cycle, the patient suddenly developed deafness and blurred vision. The patient was diagnosed with sudden sensorineural deafness and acute optic neuritis after otorhinolaryngologist consultation. His sudden sensorineural deafness and acute optic neuritis were considered to be associated with oxaliplatin. Chemotherapy was discontinued and the patient was given neurotrophic and microcirculation-improving medications. One 1 week later, the patient′s vision gradually returned to normal, but the deafness persisted.

A 59-year-old male patient received SOX chemotherapy regimen (IV infusion of oxaliplatin injection 200 mg dissolved in 5% glucose injection 250 ml for 2 hours on the first day, oral tegafur, gimeracil and oteracil potassium 60 mg once daily on day 1-14, every 3 weeks was a cycle) for gastric cancer with multiple lymph nodes metastases. One week after the infusion of oxaliplatin during the third cycle, the patient suddenly developed deafness and blurred vision. The patient was diagnosed with sudden sensorineural deafness and acute optic neuritis after otorhinolaryngologist consultation. His sudden sensorineural deafness and acute optic neuritis were considered to be associated with oxaliplatin. Chemotherapy was discontinued and the patient was given neurotrophic and microcirculation-improving medications. One 1 week later, the patient′s vision gradually returned to normal, but the deafness persisted.