Zhao Chenghao, Xiang Zhanwang, Li Mingan, Wang Haofan, Liu Huan, Yan Huzheng, Huang Mingsheng
Department of Interventional Radiology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, People's Republic of China.
J Hepatocell Carcinoma. 2023 Jul 25;10:1195-1206. doi: 10.2147/JHC.S418256. eCollection 2023.
Combined transarterial chemoembolization (TACE) and Lenvatinib (LEN) treatment (LEN-TACE) has been shown to be beneficial. We aimed to evaluate retrospectively Atezolizumab plus Bevacizumab (Atezo/Bev)-TACE compared with LEN-TACE as a first-line therapy for unresectable HCC.
From October 2020 to October 2022, data from 98 consecutive HCC patients were analyzed. After propensity score matching, two cohorts of 34 patients who received either Atezo/Bev-TACE or LEN-TACE were studied. We compared overall survival (OS), progression-free survival (PFS), duration of response, objective response rate (ORR) and disease control rate (DCR) based on RECIST 1.1 and mRECIST, as well as safety outcome between the two cohorts.
The 6-month and 12-month OS rates were 85.3% (95% CI 73.5-97.0) and 75.4% (95% CI 53.6-85.7) in the Atezo/Bev-TACE group, and 88.2% (95% CI 76.5-97.1) and 79.2% (95% CI 63.6-90.9) in the LEN-TACE group, respectively. The hazard ratio for death in the Atezo/Bev-TACE group compared to the LEN-TACE group was 1.09 (95% CI 0.47-2.51; P = 0.837). The median PFS was 7.03 months (95% CI 3.89-10.17) in the Atezo/Bev-TACE group and 6.03 months (95% CI 0-14.14) in the LEN-TACE group (HR 1.21; 95% CI 0.66-2.21; P = 0.545). No significant difference in ORR and DCR between the two groups was observed either according to RECIST 1.1 or mRECIST standards. Incidence rates of hand-foot skin reaction (35.3% vs 5.9%, P = 0.003) and proteinuria (17.9% vs 2.9%, P = 0.046) were significantly higher in the LEN-TACE group.
Atezo/Bev-TACE and LEN-TACE showed comparable efficacy and safety as first-line therapies for unresectable HCC patients.
已证明经动脉化疗栓塞术（TACE）联合乐伐替尼（LEN）治疗（LEN-TACE）是有益的。我们旨在回顾性评估阿替利珠单抗联合贝伐单抗（Atezo/Bev）-TACE与LEN-TACE作为不可切除肝癌一线治疗方案的疗效。
分析了2020年10月至2022年10月期间98例连续肝癌患者的数据。经过倾向评分匹配后，对34例接受Atezo/Bev-TACE或LEN-TACE治疗的患者进行了研究。我们根据RECIST 1.1和mRECIST标准比较了总生存期（OS）、无进展生存期（PFS）、缓解持续时间、客观缓解率（ORR）和疾病控制率（DCR），以及两组之间的安全性结果。
Atezo/Bev-TACE组的6个月和12个月OS率分别为85.3%（95%CI 73.5-97.0）和75.4%（95%CI 53.6-85.7），LEN-TACE组分别为88.2%（95%CI 76.5-97.1）和79.2%（95%CI 63.6-90.9）。与LEN-TACE组相比，Atezo/Bev-TACE组的死亡风险比为1.09（95%CI 0.47-2.51；P = 0.837）。Atezo/Bev-TACE组的中位PFS为7.03个月（95%CI 3.89-10.17），LEN-TACE组为6.03个月（95%CI 0-14.14）（HR 1.21；95%CI 0.66-2.21；P = 0.545）。根据RECIST 1.1或mRECIST标准，两组之间的ORR和DCR均未观察到显著差异。LEN-TACE组的手足皮肤反应发生率（35.3%对5.9%，P = 0.003）和蛋白尿发生率（17.9%对2.9%，P = 0.046）显著更高。
Atezo/Bev-TACE和LEN-TACE作为不可切除肝癌患者的一线治疗方案，显示出相当的疗效和安全性。
