阿替利珠单抗联合贝伐珠单抗治疗多种激酶抑制剂治疗失败的晚期肝细胞癌。

Atezolizumab plus bevacizumab in advanced hepatocellular carcinoma after treatment failure with multikinase inhibitors.

机构信息

Department of Hepatology and Gastroenterology, Nancy University Hospital, University of Lorraine, 54500 Vandœuvre-lès-Nancy, France; INSERM U1256, NGERE, Faculty of Medicine, University of Lorraine, 54500 Vandœuvre-lès-Nancy, France.

Liver Unit, Bobigny; University of Sorbonne Paris Nord, F-93000 Bobigny, France.

出版信息

Dig Liver Dis. 2023 Jul;55(7):938-944. doi: 10.1016/j.dld.2023.03.005. Epub 2023 Apr 3.

DOI:10.1016/j.dld.2023.03.005

PMID:37019737

Abstract

BACKGROUND AND AIMS

Data on the effectiveness of atezolizumab plus bevacizumab (atezo-bev) after failure of multikinase inhibitor (MKI) therapy in patients with advanced hepatocellular carcinoma are scarce.

METHODS

This retrospective multicentre study included all consecutive patients treated with atezo-bev after failing one or more MKI treatments in the setting of an early access program. The primary endpoint was the objective response rate (ORR) by investigator assessment (using Response Evaluation Criteria in Solid Tumors v1.1). Overall survival (OS) and progression-free survival (PFS) were assessed using the Kaplan‒Meier method.

RESULTS

Fifty patients were included in this analysis. Atezo-bev was started between April 2020 and November 2021 (median follow-up, 18.21 months). The investigator-assessed ORR was 14% (95% CI 5.37-22.63%), with 7 patients displaying a tumour response, and the disease control rate was 56% (95% CI 51.21-60.8%). After starting atezo-bev, the median OS was 17.1 months (95% CI 10.58-22.01), and the median PFS was 7.99 months (95% CI 4.78-10.50). Treatment-related adverse events led to treatment discontinuation in 7 patients.

CONCLUSIONS

Atezo-bev every three weeks showed clinical benefit for a proportion of patients previously treated with one or multiple lines of MKIs.

摘要

背景与目的

在晚期肝细胞癌患者中，多激酶抑制剂 (MKI) 治疗失败后使用阿替利珠单抗联合贝伐珠单抗 (atezo-bev) 的疗效数据有限。

方法

本回顾性多中心研究纳入了所有在早期准入计划中接受过一种或多种 MKI 治疗后，使用 atezo-bev 治疗的连续患者。主要终点是研究者评估的客观缓解率 (ORR)（使用实体瘤反应评估标准 1.1 版）。总生存期 (OS) 和无进展生存期 (PFS) 采用 Kaplan-Meier 法评估。

结果

本分析纳入了 50 例患者。atezo-bev 于 2020 年 4 月至 2021 年 11 月开始使用（中位随访时间 18.21 个月）。研究者评估的 ORR 为 14%（95%CI 5.37-22.63%），7 例患者显示肿瘤有反应，疾病控制率为 56%（95%CI 51.21-60.8%）。开始使用 atezo-bev 后，中位 OS 为 17.1 个月（95%CI 10.58-22.01），中位 PFS 为 7.99 个月（95%CI 4.78-10.50）。有 7 例患者因治疗相关不良事件而停止治疗。