Xiang Yan-Jun, Wang Kang, Yu Hong-Ming, Li Xiao-Wei, Cheng Yu-Qiang, Wang Wei-Jun, Feng Jin-Kai, Bo Meng-Han, Qin Ying-Yi, Zheng Yi-Tao, Shan Yun-Feng, Zhou Li-Ping, Zhai Jian, Cheng Shu-Qun
Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, China.
Department of Hepatobiliary Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
Hepatol Res. 2022 Aug;52(8):721-729. doi: 10.1111/hepr.13773. Epub 2022 May 22.
Transarterial chemoembolization (TACE) combined with a PD-1 inhibitor and TACE combined with a PD-1 inhibitor and lenvatinib have recently been reported as promising treatments to improve the prognosis of hepatocellular carcinoma (HCC) patients. This study aims to compare the efficacy of these two treatments.
A retrospective study was conducted, and patients were recruited from two centers in China. Progression-free survival (PFS) and overall survival (OS) were compared, and the objective response rate (ORR) and disease control rate (DCR) were evaluated according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST). Treatment-related adverse events (AEs) were analyzed to assess safety.
The median follow-up for the entire cohort was 11.4 months. Of the 103 patients included in this study, 56 received triple therapy, and 47 received doublet therapy. PFS was significantly higher in the triple therapy group than in the doublet therapy group (mPFS 22.5 vs. 14.0 months, P < 0.001). Similar results were obtained in terms of OS (P = 0.001). The ORR and DCR were also better in the triple therapy group (64.3% vs. 38.3%, P = 0.010; 85.7% vs. 57.4%, P = 0.002). The most common AEs in the triple therapy group were decreased albumin (55.3%), decreased platelet count (51.8%) and hypertension (44.6%).
The combination of TACE with a PD-1 inhibitor and lenvatinib in patients with BCLC stage B HCC might result in significantly improved clinical outcomes with a manageable safety profile compared with TACE with a PD-1 inhibitor.
经动脉化疗栓塞术（TACE）联合程序性死亡受体1（PD-1）抑制剂以及TACE联合PD-1抑制剂和乐伐替尼最近被报道为有望改善肝细胞癌（HCC）患者预后的治疗方法。本研究旨在比较这两种治疗方法的疗效。
进行一项回顾性研究，在中国的两个中心招募患者。比较无进展生存期（PFS）和总生存期（OS），并根据实体瘤疗效评价标准（mRECIST）评估客观缓解率（ORR）和疾病控制率（DCR）。分析治疗相关不良事件（AE）以评估安全性。
整个队列的中位随访时间为11.4个月。本研究纳入的103例患者中，56例接受三联疗法，47例接受双联疗法。三联疗法组的PFS显著高于双联疗法组（中位PFS 22.5个月对14.0个月，P<0.001）。OS方面也得到了类似结果（P=0.001）。三联疗法组的ORR和DCR也更好（64.3%对38.3%，P=0.010；85.7%对57.4%，P=0.002）。三联疗法组最常见的AE是白蛋白降低（55.3%）、血小板计数降低（51.8%）和高血压（44.6%）。
对于巴塞罗那临床肝癌（BCLC）分期为B期的HCC患者，与TACE联合PD-1抑制剂相比，TACE联合PD-1抑制剂和乐伐替尼可能会显著改善临床结局，且安全性可控。
