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肝动脉灌注化疗联合PD - 1抑制剂加仑伐替尼治疗晚期肝细胞癌:PD - 1抑制剂加仑伐替尼方案

Hepatic Arterial Infusion Chemotherapy Combined With PD-1 Inhibitors Plus Lenvatinib PD-1 Inhibitors Plus Lenvatinib for Advanced Hepatocellular Carcinoma.

作者信息

Mei Jie, Tang Yu-Hao, Wei Wei, Shi Ming, Zheng Lie, Li Shao-Hua, Guo Rong-Ping

机构信息

Department of Liver Surgery, Sun Yat-Sen University Cancer Center, Guangzhou, China.

State Key Laboratory of Oncology in South China, Guangzhou, China.

出版信息

Front Oncol. 2021 Feb 25;11:618206. doi: 10.3389/fonc.2021.618206. eCollection 2021.

Abstract

BACKGROUND

Lenvatinib combined with programmed cell death protein-1 (PD-1) inhibitors has resulted in good survival outcomes in the treatment of unresectable hepatocellular carcinoma (HCC). Hepatic artery infusion chemotherapy (HAIC) has also attracted attention due to its high response rates and favorable survival for advanced HCC patients. The present study aimed to compare the efficacy of HAIC combined with PD-1 inhibitors plus lenvatinib (HPL) and PD-1 inhibitors plus lenvatinib (PL) in patients with advanced HCC.

METHODS

Between July 2018 and December 2019, patients diagnosed with advanced HCC who initially received HPL or PL treatment were reviewed for eligibility. Efficacy was evaluated according to tumor response and survival.

RESULTS

In total, 70 patients met the criteria and were included in the present study, and they were divided into the HPL group (n = 45) and PL group (n = 25). The overall response rate (40.0 . 16.0%, respectively; p = 0.038) and disease control rate (77.6 . 44.0%, respectively; p < 0.001) were higher in the HPL group than in the PL group. The median overall survival was 15.9 months in the HPL group and 8.6 months in the PL group (p = 0.0015; HR = 0.6; 95% CI 0.43-0.83). The median progression-free survival was 8.8 months in the HPL group and 5.4 months in the PL group (p = 0.0320; HR = 0.74; 95% CI 0.55-0.98).

CONCLUSION

Compared to PL, HPL was associated with a significantly better treatment response and survival benefits for patients with advanced HCC.

摘要

背景

乐伐替尼联合程序性细胞死亡蛋白-1(PD-1)抑制剂在不可切除肝细胞癌(HCC)治疗中取得了良好的生存结果。肝动脉灌注化疗(HAIC)因其对晚期HCC患者的高缓解率和良好生存率也受到关注。本研究旨在比较HAIC联合PD-1抑制剂加乐伐替尼(HPL)与PD-1抑制剂加乐伐替尼(PL)治疗晚期HCC患者的疗效。

方法

2018年7月至2019年12月,对最初接受HPL或PL治疗的晚期HCC诊断患者进行资格审查。根据肿瘤反应和生存情况评估疗效。

结果

共有70例患者符合标准并纳入本研究,分为HPL组(n = 45)和PL组(n = 25)。HPL组的总缓解率(分别为40.0%和16.0%;p = 0.038)和疾病控制率(分别为77.6%和44.0%;p < 0.001)高于PL组。HPL组的中位总生存期为15.9个月,PL组为8.6个月(p = 0.0015;HR = 0.6;95%CI 0.43 - 0.83)。HPL组的中位无进展生存期为8.8个月,PL组为5.4个月(p = 0.0320;HR = 0.74;95%CI 0.55 - 0.98)。

结论

与PL相比,HPL对晚期HCC患者的治疗反应和生存获益显著更好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52ab/7947809/449d941d33e4/fonc-11-618206-g001.jpg

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