[Efficacy and safety of transcatheter arterial chemoembolization followed by hepatic arterial infusion chemotherapy combined with TKI and PD-1 inhibitors as first-line treatment for advanced hepatocellular carcinoma].

L Zhang, X Liu, X Hu, J Wang, X Yu, G Li, H You, Q Zhang, H Zhang
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引用次数: 0

Abstract

Objective: To evaluate the efficacy and safety of transcatheter arterial chemoembolization (TACE) followed by hepatic arterial infusion chemotherapy (HAIC) combined with TKI drugs and PD-1 inhibitors as the first-line treatment for advanced hepatocellular carcinoma (HCC).

Methods: We retrospectively analyzed the data of 70 patients with advanced HCC treated in the Department of Oncology of Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine between July, 2020 and June, 2023. 23 of the patients received TACE combined with HAIC and TKI (TACE+HAIC+ TKI group) and 47 received TACE combined with HAIC, PD-1 inhibitors and TKI (TACE+HAIC+PD-1+TKI group). The clinical characteristics, laboratory test results, efficacy, outcomes and adverse events of the patients were compared between the two groups.

Results: The TACE+HAIC+TKI and TACE+HAIC+PD-1+TKI groups had significantly different objective remission rates (ORR; 60.87% vs 36.17%, P=0.031), comparable disease control rates (95.65% vs 93.62%, P=0.068), and different median progression-free survival (PFS) time (10.2 vs 11.8 months, P=0.003) and median overall survival (OS) time (15.7 vs 19.5 months, P=0.035). After propensity score matching (PSM), the median PFS and OS time of the two groups was 10.1 vs 14.5 months (P= 0.024) and 14.2 vs 21.2 months (P=0.221), respectively. The 1-year PFS rates of the 2 groups were 24.0% vs 52.2%, and the 1-, 2-and 3-year OS rates were 72.3% vs 93.1%, 23.9% vs 63.8%, and 23.9% vs 36.5%, respectively. The incidence of proteinuria was significantly higher in TACE+HAIC+PD-1+TKI group than in TACE+HAIC+TKI group (21.28% vs 0, P=0.025), but the incidences of grade 3-4 treatment-related adverse events were all similar between the two groups.

Conclusion: The first-line treatment with TACE+HAIC+PD-1+TKI is safe and effective for advanced HCC and can significantly prolong the survival of the patients.

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[经导管动脉化疗栓塞后肝动脉灌注化疗联合 TKI 和 PD-1 抑制剂作为晚期肝细胞癌一线治疗的有效性和安全性】。]
目的评估经导管动脉化疗栓塞术(TACE)后肝动脉灌注化疗(HAIC)联合TKI药物和PD-1抑制剂作为晚期肝细胞癌(HCC)一线治疗的有效性和安全性:我们回顾性分析了2020年7月至2023年6月期间在广东省中西医结合医院肿瘤科接受治疗的70例晚期HCC患者的数据。其中23例患者接受了TACE联合HAIC和TKI治疗(TACE+HAIC+TKI组),47例患者接受了TACE联合HAIC、PD-1抑制剂和TKI治疗(TACE+HAIC+PD-1+TKI组)。对两组患者的临床特征、实验室检查结果、疗效、结局和不良事件进行了比较:结果:TACE+HAIC+TKI组和TACE+HAIC+PD-1+TKI组的客观缓解率(ORR;60.87% vs 36.17%,P=0.031)显著不同,疾病控制率(95.65% vs 93.62%,P=0.068)相当,中位无进展生存期(PFS)时间(10.2 vs 11.8个月,P=0.003)和中位总生存期(OS)时间(15.7 vs 19.5个月,P=0.035)不同。倾向得分匹配(PSM)后,两组患者的中位 PFS 和 OS 时间分别为 10.1 vs 14.5 个月(P= 0.024)和 14.2 vs 21.2 个月(P=0.221)。两组的1年PFS率分别为24.0% vs 52.2%,1年、2年和3年OS率分别为72.3% vs 93.1%、23.9% vs 63.8%和23.9% vs 36.5%。TACE+HAIC+PD-1+TKI组蛋白尿发生率明显高于TACE+HAIC+TKI组(21.28% vs 0,P=0.025),但两组3-4级治疗相关不良事件发生率相似:结论:TACE+HAIC+PD-1+TKI一线治疗晚期HCC安全有效,能显著延长患者的生存期。
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来源期刊
南方医科大学学报杂志
南方医科大学学报杂志 Medicine-Medicine (all)
CiteScore
1.50
自引率
0.00%
发文量
208
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