Hu Yue, Pan Tao, Cai Xi, He Quan-Sheng, Zheng Yu-Bao, Huang Ming-Sheng, Jiang Zai-Bo, Chen Jun-Wei, Wu Chun
Department of Interventional Radiology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China.
J Gastrointest Oncol. 2023 Aug 31;14(4):1837-1848. doi: 10.21037/jgo-23-486. Epub 2023 Aug 14.
Transarterial chemoembolization (TACE) is the standard treatment for hepatocellular carcinoma (HCC); the value of its combination with systemic therapy is worthy of further exploration. This study aimed to investigate the efficacy and safety of TACE combined with tyrosine kinase inhibitor (TKI) and immune checkpoint inhibitor (ICI) in the treatment of unresectable HCC.
In this retrospective observational, single-center study, 147 patients with unresectable HCC were divided into a TACE group (n=98) and a non-TACE group (n=49) based on whether TACE was performed during TKI plus ICI therapy. The survival outcomes and adverse events (AEs) of the two groups were compared.
Data from patients with unresectable HCC who received TKI plus ICI treatment between July 2017 and April 2020 were collected. The median intrahepatic tumor size was 8.7 cm [interquartile range (IQR), 5.9-12.4 cm]. At data cut-off, overall survival (OS) of the TACE group was significantly longer than that of the non-TACE group (19.5 and 10.8 months, respectively, P=0.005). In the high-risk cohort (with main or contralateral portal vein tumor thrombi and/or bile duct invasion and/or a tumor burden >50% of liver), the OS of the TACE group was still longer than that of the non-TACE group (14.9 and 8.7 months, respectively, P=0.031). Major AEs were tolerated in both groups, and there was no significant difference in their incidence (34.7% and 30.6%, respectively, P=0.621).
TACE treatment combined with TKI plus ICI regime resulted in longer OS than treatment with TKI plus ICI alone for patients with unresectable HCC.
经动脉化疗栓塞术（TACE）是肝细胞癌（HCC）的标准治疗方法；其与全身治疗联合应用的价值值得进一步探索。本研究旨在探讨TACE联合酪氨酸激酶抑制剂（TKI）和免疫检查点抑制剂（ICI）治疗不可切除HCC的疗效和安全性。
在这项回顾性观察性单中心研究中，147例不可切除HCC患者根据在TKI加ICI治疗期间是否进行TACE分为TACE组（n = 98）和非TACE组（n = 49）。比较两组的生存结局和不良事件（AE）。
收集了2017年7月至2020年4月期间接受TKI加ICI治疗的不可切除HCC患者的数据。肝内肿瘤中位大小为8.7 cm [四分位间距（IQR），5.9 - 12.4 cm]。在数据截止时，TACE组的总生存期（OS）显著长于非TACE组（分别为19.5个月和10.8个月，P = 0.005）。在高危队列（有主要或对侧门静脉肿瘤血栓和/或胆管侵犯和/或肿瘤负荷>肝脏的50%）中，TACE组的OS仍长于非TACE组（分别为14.9个月和8.7个月，P = 0.031）。两组对主要AE均耐受，其发生率无显著差异（分别为34.7%和30.6%，P = 0.621）。
对于不可切除HCC患者，TACE治疗联合TKI加ICI方案比单独使用TKI加ICI治疗的OS更长。
