Clinical Therapy: HAIC Combined with Tyrosine Kinase Inhibitors and Programmed Cell Death Protein-1 Inhibitors versus HAIC Alone for Unresectable Hepatocellular Carcinoma

IF 4.2 3区 医学 Q2 ONCOLOGY Journal of Hepatocellular Carcinoma Pub Date : 2024-08-12 DOI:10.2147/jhc.s470345
Baokun Liu, Lujun Shen, Wen Liu, Zhiyong Zhang, Jieqiong Lei, Zhengguo Li, Qinquan Tan, Hengfei Huang, Xingdong Wang, Weijun Fan
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Abstract

Purpose: The majority of new diagnoses of hepatocellular carcinoma (HCC) still pertain to unresectable cases. Currently, the combination therapy of tyrosine kinase inhibitors (TKIs) and programmed cell death protein-1 (PD-1) inhibitors has become the mainstream treatment. According to multiple clinical guidelines, it is strongly advised to consider local therapy as the primary treatment choice for uHCC. This research was conducted to examine the safety and effectiveness of combining hepatic arterial infusion chemotherapy (HAIC) with TKIs and PD-1 inhibitors for the treatment of uHCC.
Methods: Between 2015 and 2020, 208 HCC patients received HAIC alone or HAIC in combination with TKIs and PD-1 inhibitors. The overall survival(OS), and progression-free survival(PFS) and the best treatment response were compared between the two treatment groups. Propensity score matching (PSM)was used to minimize confounding bias.
Results: Among the enrolled patients, 116 patients (55.8%) received combination therapy, while 92 patients (44.2%) received HAIC alone. The baseline characteristics were similar between the two groups. After PSM, 82 pairs of well-matched liver cancer patients were selected; the overall response rate in the combination group trended better than that in the HAIC alone group. The hazard ratios (HRs) for OS and PFS of the combination approach compared to the HAIC-alone approach were 0.47 (95% CI, 0.322– 0.687; p< 0.001) and 0.58 (95% CI, 0.397– 0.848; p=0.005), respectively.
Conclusion: For uHCC patients, combination therapy can provide better OS and PFS compared to HAIC alone.

Keywords: hepatocellular carcinoma, TKIs, PD-1, HAIC, combination therapy
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临床疗法:HAIC联合酪氨酸激酶抑制剂和程序性细胞死亡蛋白-1抑制剂与单用HAIC治疗无法切除的肝细胞癌比较
目的:大多数新诊断的肝细胞癌(HCC)仍属于无法切除的病例。目前,酪氨酸激酶抑制剂(TKIs)和程序性细胞死亡蛋白-1(PD-1)抑制剂的联合治疗已成为主流治疗方法。根据多项临床指南,强烈建议将局部治疗作为uHCC的主要治疗选择。本研究旨在探讨肝动脉灌注化疗(HAIC)与TKIs和PD-1抑制剂联合治疗uHCC的安全性和有效性:2015年至2020年间,208名HCC患者接受了HAIC单独治疗或HAIC与TKIs和PD-1抑制剂联合治疗。比较两组患者的总生存期(OS)、无进展生存期(PFS)和最佳治疗反应。研究采用倾向评分匹配法(PSM)来减少混杂偏倚:在入组患者中,116 名患者(55.8%)接受了联合治疗,92 名患者(44.2%)接受了单药 HAIC 治疗。两组患者的基线特征相似。经过PSM筛选,选出了82对匹配度较高的肝癌患者;联合治疗组的总体反应率呈上升趋势,优于单用HAIC组。与单用HAIC相比,联合治疗组的OS和PFS危险比(HRs)分别为0.47(95% CI,0.322- 0.687;p< 0.001)和0.58(95% CI,0.397- 0.848;p=0.005):关键词:肝细胞癌;TKIs;PD-1;HAIC;联合治疗
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来源期刊
CiteScore
0.50
自引率
2.40%
发文量
108
审稿时长
16 weeks
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