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社区肿瘤环境中晚期肝细胞癌患者按Child-Pugh分级的临床结局

Clinical outcomes by Child-Pugh Class in patients with advanced hepatocellular carcinoma in a community oncology setting.

作者信息

Aly Abdalla, Fulcher Nicole, Seal Brian, Pham Trang, Wang Yunfei, Paulson Scott, He Aiwu R

机构信息

AstraZeneca, Gaithersburg, MD 20278, USA.

McKesson Life Sciences, The Woodlands, TX 77380, USA.

出版信息

Hepat Oncol. 2023 Aug 9;10(1):HEP47. doi: 10.2217/hep-2023-0002. eCollection 2023 Mar.

Abstract

AIM

Many pivotal trials in advanced hepatocellular carcinoma (HCC) require participants to have Child-Pugh A disease. However, many patients in real-world practice are Child-Pugh B or C. This study examined treatment patterns and clinical outcomes in patients with advanced HCC treated with first-line systemic therapy.

MATERIALS & METHODS: In this retrospective study, patients with HCC treated with first-line systemic therapy (2010-2017) were identified from US Oncology Network records. Outcomes included overall survival and progression-free survival, by Child-Pugh Class and prior liver-directed therapy.

RESULTS

Of 352 patients, 78.7% were Child-Pugh A or B, 96.6% received first-line sorafenib, and 33.8% received first-line-prior liver-directed therapy. Survival outcomes were similar for Child-Pugh A or B, and longer after first-line prior liver-directed therapy.

CONCLUSION

First-line systemic therapy is beneficial in patients with Child-Pugh A or B, and after first-line prior liver-directed therapy. These findings may help position systemic therapy in the community setting.

摘要

目的

许多晚期肝细胞癌(HCC)的关键试验要求参与者患有Child-Pugh A级疾病。然而,在实际临床实践中,许多患者为Child-Pugh B级或C级。本研究调查了接受一线全身治疗的晚期HCC患者的治疗模式和临床结局。

材料与方法

在这项回顾性研究中,从美国肿瘤学网络记录中识别出接受一线全身治疗(2010 - 2017年)的HCC患者。结局指标包括总生存期和无进展生存期,按Child-Pugh分级和既往肝脏定向治疗情况进行分析。

结果

352例患者中,78.7%为Child-Pugh A级或B级,96.6%接受一线索拉非尼治疗,33.8%接受一线既往肝脏定向治疗。Child-Pugh A级或B级患者的生存结局相似,一线既往肝脏定向治疗后的生存期更长。

结论

一线全身治疗对Child-Pugh A级或B级患者以及一线既往肝脏定向治疗后的患者有益。这些发现可能有助于在社区环境中定位全身治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a36b/10413176/bba1535fb825/hep-10-47-g1.jpg

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