经动脉化疗栓塞联合乐伐替尼和程序性死亡受体（配体）1抑制剂治疗不可切除肝细胞癌的疗效与安全性：一项回顾性研究
Efficacy and Safety of TACE Combined with Lenvatinib and PD-(L)1 Inhibitor in the Treatment of Unresectable Hepatocellular Carcinoma: A Retrospective Study.
作者信息
Yang Hui, Yang Tiequan, Qiu Guangpin, Liu Jie
机构信息
Department of Interventional Therapy, Ningbo NO.2 Hospital, Ningbo, Zhejiang, People's Republic of China.
出版信息
J Hepatocell Carcinoma. 2023 Sep 5;10:1435-1443. doi: 10.2147/JHC.S423684. eCollection 2023.
PURPOSE
In the study, patients with unresectable hepatocellular carcinoma (uHCC) were treated with either transcatheter chemoembolization (TACE) combined with lenvatinib and PD-(L)1 inhibitor (TACE-L-P) or TACE combined with lenvatinib (TACE-L). We compared the efficacy and safety of TACE-L-P with TACE-L, and analyzed factors affecting prognosis.
MATERIALS AND METHODS
A total of 122 patients were treated with either TACE-L-P (n = 64) or TACE-L (n = 58), and their data was collected and analyzed. We assessed tumor response, progression-free survival (PFS), prognostic factors for PFS and adverse events (AEs) to compare the efficacy and safety of TACE-L-P with TACE-L for patients with uHCC.
RESULTS
TACE-L-P group's patients had a better objective response rate (ORR) (57.8% vs 41.4%, P = 0.047) and a better disease control rate (93.7% vs 81%, P = 0.013), as long as a longer median progression-free survival (PFS) (8 months vs 4.6 months, HR: 0.461; 95% CI: [0.314-0.675]; P = 0.001) than TACE-L group's patients. According to multivariate analysis, independent prognostic factors for PFS included treatment option (TACE-L-P / TACE-L; RH = 0.461; 95% CI [0.314-0.675]; P = 0.001), PVTT (Yes/No; RH =1 0.599;95% CI [1 0.095-2 0.336]; P=0 0.017), extrahepatic metastasis (Yes/No; RH=1 0.847;95% CI [1 0.176 -2 0.909]; P=0 0.008). AEs in TACE-L-P group was similar with TACE-L group.
CONCLUSION
TACE-L-P has more promising clinical outcomes in patients with uHCC than TACE-L, and their safety is similar.
目的
在本研究中，不可切除肝细胞癌（uHCC）患者接受了经动脉化疗栓塞（TACE）联合乐伐替尼及程序性死亡受体（配体）1抑制剂（TACE-L-P）或TACE联合乐伐替尼（TACE-L）治疗。我们比较了TACE-L-P与TACE-L的疗效和安全性，并分析了影响预后的因素。
材料与方法
共有122例患者接受了TACE-L-P（n = 64）或TACE-L（n = 58）治疗，并收集和分析了他们的数据。我们评估了肿瘤反应、无进展生存期（PFS）、PFS的预后因素及不良事件（AE），以比较TACE-L-P与TACE-L对uHCC患者的疗效和安全性。
结果
TACE-L-P组患者具有更好的客观缓解率（ORR）（57.8%对41.4%，P = 0.047）和更好的疾病控制率（93.7%对81%，P = 0.013），且中位无进展生存期（PFS）更长（8个月对4.6个月，HR：0.461；95%CI：[0.314 - 0.675]；P = 0.001），优于TACE-L组患者。多因素分析显示，PFS的独立预后因素包括治疗方案（TACE-L-P/TACE-L；RH = 0.461；95%CI [0.314 - 0.675]；P = 0.001）、门静脉癌栓（PVTT，存在/不存在；RH = 0.599；95%CI [0.095 - 0.336]；P = 0.017）、肝外转移（存在/不存在；RH = 0.847；95%CI [0.176 - 0.909]；P = 0.008）。TACE-L-P组的AE与TACE-L组相似。
结论
对于uHCC患者，TACE-L-P比TACE-L具有更有前景的临床结局，且安全性相似。
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