程序性细胞死亡蛋白1（PD-1）靶向免疫疗法在真实世界中治疗晚期肝细胞癌的应用
Programmed Cell Death Protein-1 (PD-1)-Targeted Immunotherapy for Advanced Hepatocellular Carcinoma in Real World.
作者信息
Cui Hanzhi, Dai Guanghai, Guan Jingzhi
机构信息
Department of Oncology, The Eighth Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China.
Department of Oncology, The General Hospital of People's Liberation Army, Beijing, People's Republic of China.
出版信息
Onco Targets Ther. 2020 Jan 8;13:143-149. doi: 10.2147/OTT.S234868. eCollection 2020.
BACKGROUND
Hepatocellular carcinoma (HCC) is one of the most common malignant solid tumors. Its incidence is increasing worldwide due to the dissemination of hepatitis B infection, HCV infection and nonalcoholic steatohepatitis-related HCC. For patients with advanced HCC, the available treatments are extremely limited and the prognosis is very poor. Therefore, it is urgent to discover new innovative approaches. Programmed cell death protein-1-targeted immunotherapy has shown promising results in multicenter clinical trials.
AIM
To evaluate the effectiveness and safety of anti-PD-1 agent in patients with advanced primary hepatocellular carcinoma.
METHODS
A retrospective analysis of 55 patients with advanced primary hepatocellular carcinoma who had been administered anti-PD-1 agent. Tumor response was assessed according to the modified Response Evaluation Criteria in Solid Tumors and any adverse events were recorded.
RESULTS
The median overall survival (OS) was 15 months. The median progression-free survival (PFS) was 10 months. No patient had complete response (CR) and 12 (22%) participants achieved partial response (PR), resulting in an overall response rate (ORR) of 22%. Thirty-seven (67%) patients showed stable disease (SD) and 6 (11%) subjects had progressive disease (PD) at first radiological evaluation. The disease control rate (DCR) was 89%. The total side effect rate was 61.8% and most were relieved after treatment.
CONCLUSION
Programmed cell death protein-1-targeted immunotherapy is a safe and effective treatment for advanced primary hepatocellular carcinoma.
背景
肝细胞癌（HCC）是最常见的恶性实体肿瘤之一。由于乙型肝炎感染、丙型肝炎病毒（HCV）感染以及非酒精性脂肪性肝炎相关的HCC传播，其在全球的发病率正在上升。对于晚期HCC患者，可用的治疗方法极为有限，预后很差。因此，迫切需要发现新的创新方法。程序性细胞死亡蛋白1靶向免疫疗法在多中心临床试验中已显示出有前景的结果。
目的
评估抗程序性死亡蛋白1（PD-1）药物治疗晚期原发性肝细胞癌患者的有效性和安全性。
方法
对55例接受抗PD-1药物治疗的晚期原发性肝细胞癌患者进行回顾性分析。根据改良的实体瘤疗效评价标准评估肿瘤反应，并记录所有不良事件。
结果
中位总生存期（OS）为15个月。中位无进展生存期（PFS）为10个月。无患者达到完全缓解（CR），12例（22%）参与者达到部分缓解（PR），总缓解率（ORR）为22%。在首次影像学评估时，37例（67%）患者疾病稳定（SD），6例（11%）患者疾病进展（PD）。疾病控制率（DCR）为89%。总副作用发生率为61.8%，大多数在治疗后缓解。
结论
程序性细胞死亡蛋白1靶向免疫疗法是晚期原发性肝细胞癌的一种安全有效的治疗方法。
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