Center of Interventional Radiology & Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, 210009, China.
Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou, 215006, China.
Eur Radiol. 2023 Dec;33(12):8669-8681. doi: 10.1007/s00330-023-09754-2. Epub 2023 Jun 27.
This study aimed to investigate the efficacy and safety of transarterial chemoembolization (TACE) plus camrelizumab, a monoclonal antibody targeting programmed death-1, and apatinib for patients with intermediate and advanced hepatocellular carcinoma (HCC) in a real-world setting.
A total of 586 HCC patients treated with either TACE plus camrelizumab and apatinib (combination group, n = 107) or TACE monotherapy (monotherapy group, n = 479) were included retrospectively. Propensity score matching analysis was used to match patients. The overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and safety in the combination group were described in comparison to monotherapy.
After propensity score matching (1:2), 84 patients in the combination group were matched to 147 patients in the monotherapy group. The median age was 57 years and 71/84 (84.5%) patients were male in the combination group, while the median age was 57 years with 127/147 (86.4%) male in the monotherapy group. The median OS, PFS, and ORR in the combination group were significantly higher than those in the monotherapy group (median OS, 24.1 vs. 15.7 months, p = 0.008; median PFS, 13.5 vs. 7.7 months, p = 0.003; ORR, 59.5% [50/84] vs. 37.4% [55/147], p = 0.002). On multivariable Cox regression, combination therapy was associated with significantly better OS (adjusted hazard ratio [HR], 0.41; 95% confidence interval [CI], 0.26-0.64; p < 0.001) and PFS (adjusted HR, 0.52; 95% CI, 0.37-0.74; p < 0.001). Grade 3 or 4 adverse events occurred in 14/84 (16.7%) and 12/147 (8.2%) in the combination and monotherapy groups, respectively.
TACE plus camrelizumab and apatinib showed significantly better OS, PFS, and ORR versus TACE monotherapy for predominantly advanced HCC.
Compared with TACE monotherapy, TACE plus immunotherapy and molecular targeted therapy showed better clinical efficacy for predominantly advanced HCC patients, with a higher incidence of adverse events.
• This propensity score-matched study demonstrates that TACE plus immunotherapy and molecular targeted therapy have a longer OS, PFS, and ORR compared with TACE monotherapy in HCC. • Grade 3 or 4 adverse events occurred in 14/84 (16.7%) patients treated with TACE plus immunotherapy and molecular targeted therapy compared with 12/147 (8.2%) patients in the monotherapy group, while no grade 5 adverse events were observed in all cohorts.
本研究旨在探讨在真实世界环境中，经动脉化疗栓塞术（TACE）联合程序性死亡受体-1 单抗卡瑞利珠单抗和安罗替尼治疗中晚期肝细胞癌（HCC）患者的疗效和安全性。
回顾性纳入 586 例接受 TACE 联合卡瑞利珠单抗和安罗替尼（联合组，n=107）或 TACE 单药治疗（单药组，n=479）的 HCC 患者。采用倾向性评分匹配分析进行患者匹配。比较联合组与单药组的总生存期（OS）、无进展生存期（PFS）、客观缓解率（ORR）和安全性。
经倾向性评分匹配（1:2）后，联合组 84 例患者匹配至单药组 147 例患者。联合组患者的中位年龄为 57 岁，71/84（84.5%）例为男性；单药组患者的中位年龄为 57 岁，127/147（86.4%）例为男性。联合组的中位 OS、PFS 和 ORR 均显著高于单药组（中位 OS：24.1 个月 vs. 15.7 个月，p=0.008；中位 PFS：13.5 个月 vs. 7.7 个月，p=0.003；ORR：59.5%[50/84] vs. 37.4%[55/147]，p=0.002）。多变量 Cox 回归分析显示，联合治疗与显著更好的 OS（调整后的 hazard ratio [HR]，0.41；95%置信区间 [CI]，0.26-0.64；p<0.001）和 PFS（调整后的 HR，0.52；95% CI，0.37-0.74；p<0.001）相关。联合组和单药组分别有 14/84（16.7%）和 12/147（8.2%）例患者发生 3 级或 4 级不良事件。
与 TACE 单药治疗相比，TACE 联合卡瑞利珠单抗和安罗替尼治疗中晚期 HCC 患者的 OS、PFS 和 ORR 显著提高。
与 TACE 单药治疗相比，TACE 联合免疫治疗和分子靶向治疗对中晚期 HCC 患者具有更好的临床疗效，但不良反应发生率更高。
• 本倾向评分匹配研究表明，与 TACE 单药治疗相比，TACE 联合免疫治疗和分子靶向治疗可使 HCC 患者的 OS、PFS 和 ORR 更长。
• 联合治疗组 14/84（16.7%）例患者发生 3 级或 4 级不良事件，单药治疗组 12/147（8.2%）例患者发生 3 级或 4 级不良事件，而所有队列均未观察到 5 级不良事件。
Zotero 插件
