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卡瑞利珠单抗联合阿帕替尼作为不可切除肝细胞癌二线治疗的临床疗效及安全性分析:一项多中心回顾性研究

[Clinical efficacy and safety analysis of camrelizumab combined with apatinib as a second-line therapy for unresectable hepatocellular carcinoma: a multicenter retrospective study].

作者信息

Yuan G S, He W M, Hu X Y, Li Q, Zang M Y, Cheng X, Huang W, Ruan J, Wang J J, Hou J L, Chen J Z

机构信息

Department of Infectious Diseases and Hepatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.

Department of Hepatology, Zengcheng Branch of Nanfang Hospital, Southern Medical University, Zengcheng 511300, China.

出版信息

Zhonghua Gan Zang Bing Za Zhi. 2021 Apr 20;29(4):326-331. doi: 10.3760/cma.j.cn501113-20210329-00148.

Abstract

To analyze the clinical efficacy and safety of camrelizumab combined with apatinib as a second-line therapy for unresectable hepatocellular carcinoma (HCC). Ninety-four cases with mid-and advanced-stage HCC who received camrelizumab combined with apatinib as second-line treatment were enrolled. Routine blood test, blood biochemical indexes, tumor stage, tumor imaging characteristics, previous treatment strategies and other clinical data before treatment were documented. Imaging examination follow-up results and adverse reactions during treatment were followed up until the end of follow-up or loss of follow-up or death. Kaplan-Meier method was used to analyze the clinical efficacy. As of the last follow-up, 94 cases with mid-and advanced-stage HCC had received camrelizumab combined with apatinib as second-line treatment. Among them, 15 cases were lost to follow-up, 31 cases died, and 48 cases survived. The overall remission rate was 31.9%. The overall disease control rate was 71.3%. The median time to disease-free progression was 6.6 months. The median time to disease progression was not yet available. The 1-year cumulative survival rate was 62.3%. Grade 3 and above adverse reactions mainly included were thrombocytopenia (7.4%), abdominal pain (4.3%), active hepatitis (4.3%), leukopenia (4.3%), diarrhea (3.2%), hand-foot syndrome (3.2%). All adverse reactions were effectively controlled. Camrelizumab combined with apatinib can effectively prolong the survival period of patients with mid-and advanced-stage HCC, and it is well tolerated.

摘要

分析卡瑞利珠单抗联合阿帕替尼作为不可切除肝细胞癌(HCC)二线治疗的临床疗效和安全性。纳入94例接受卡瑞利珠单抗联合阿帕替尼作为二线治疗的中晚期HCC患者。记录治疗前的血常规、血液生化指标、肿瘤分期、肿瘤影像学特征、既往治疗策略等临床资料。随访影像学检查结果及治疗期间的不良反应,直至随访结束、失访或死亡。采用Kaplan-Meier法分析临床疗效。截至最后一次随访,94例中晚期HCC患者接受了卡瑞利珠单抗联合阿帕替尼作为二线治疗。其中,15例失访,31例死亡,48例存活。总缓解率为31.9%。疾病控制率为71.3%。无进展生存期的中位数为6.6个月。疾病进展时间的中位数尚未得出。1年累积生存率为62.3%。3级及以上不良反应主要包括血小板减少(7.4%)、腹痛(4.3%)、活动性肝炎(4.3%)、白细胞减少(4.3%)、腹泻(3.2%)、手足综合征(3.2%)。所有不良反应均得到有效控制。卡瑞利珠单抗联合阿帕替尼可有效延长中晚期HCC患者的生存期,且耐受性良好。

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