Department of Hematology and Oncology (Key Discipline of Jiangsu Medicine), Medical School, Zhongda Hospital, Southeast University, 210009, Nanjing, Jiangsu Province, P.R. China.
Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, 210029, Nanjing, Jiangsu Province, P.R. China.
Invest New Drugs. 2022 Oct;40(5):1125-1132. doi: 10.1007/s10637-022-01257-z. Epub 2022 Jul 6.
Conversion therapy has been widely applied in various cancer types including intrahepatic cholangiocarcinoma (ICC). The aim of this retrospective study was to evaluate the efficacy and safety of transarterial chemoembolization combined with lenvatinib (TACE-L) as a novel conversion therapy in patients with initially unresectable ICC.
Enrolled in this retrospective study were patients with unresectable ICC who received TACE-L between January 2015 and May 2018. The patients were evaluated every 2 months for possible secondary resection.
Of the 44 eligible patients, 28 (63.6%) were successfully downstaged to receive surgical resection and the other 16 patients were included into the unsuccessfully downstaged group. The overall adverse events during TACE-L were moderate, including 12 patients (27.3%) with Grade 3 or 4 toxicities. Of the 28 downregulated patients, 23 (82.1%) achieved an R0 resection, and 6 (21.4%) had Clavien-Dindo grade ≥ 3 complications, including one postoperative death. Kaplan-Meier curves showed that the successfully downstaged patients had better overall survival (OS) than the unsuccessfully downstaged patients (P = 0.006). Multivariable analysis identified successful TACE-L conversion therapy as a significantly favorable prognostic factor for OS.
TACE-L proves to be a safe and efficacious conversion therapy modality that allows for secondary resectability in patients with initially unresectable ICC.
转化治疗已广泛应用于包括肝内胆管癌（ICC）在内的多种癌症类型。本回顾性研究旨在评估经肝动脉化疗栓塞联合仑伐替尼（TACE-L）作为一种新的转化治疗方法，在初治不可切除的 ICC 患者中的疗效和安全性。
本回顾性研究纳入了 2015 年 1 月至 2018 年 5 月期间接受 TACE-L 治疗的不可切除 ICC 患者。每 2 个月对患者进行评估，以确定是否可以进行二次手术切除。
44 名符合条件的患者中，有 28 名（63.6%）成功降期接受了手术切除，其余 16 名患者归入未成功降期组。TACE-L 期间的总体不良事件为中度，包括 12 名（27.3%）患者出现 3 级或 4 级毒性。在 28 名降期的患者中，23 名（82.1%）实现了 R0 切除，6 名（21.4%）发生了 Clavien-Dindo 分级≥3 的并发症，包括 1 例术后死亡。Kaplan-Meier 曲线显示，成功降期的患者总生存期（OS）优于未成功降期的患者（P=0.006）。多变量分析确定成功的 TACE-L 转化治疗是 OS 的显著有利预后因素。
TACE-L 被证明是一种安全有效的转化治疗方法，可使初治不可切除的 ICC 患者获得二次手术切除的机会。
