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钇-90 放射性栓塞联合阿替利珠单抗/贝伐珠单抗或纳武利尤单抗治疗不可切除的晚期肝细胞癌的安全性和有效性。

Safety and Efficacy of Concurrent Atezolizumab/Bevacizumab or Nivolumab Combination Therapy with Yttrium-90 Radioembolization of Advanced Unresectable Hepatocellular Carcinoma.

机构信息

Department of Radiology, University of North Carolina at Chapel Hill, Alexander Villalobos 101 Manning Drive, Chapel Hill, NC 27514, USA.

Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA.

出版信息

Curr Oncol. 2023 Nov 25;30(12):10100-10110. doi: 10.3390/curroncol30120734.


DOI:10.3390/curroncol30120734
PMID:38132368
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10742675/
Abstract

To evaluate the safety and efficacy of combining yttrium-90 radioembolization (Y90-RE) with immune checkpoint inhibitor therapy, consecutive advanced unresectable hepatocellular carcinoma (HCC) patients treated between 2016 and 2022 with atezolizumab/bevacizumab or nivolumab within three-months pre- and post-Y90-RE were retrospectively evaluated. Tumor response and treatment-related clinical/laboratory adverse events (AE) were assessed at 1 and 6 months, as well as differences in clinical and laboratory variables and median overall survival (OS) from initial treatment (whether it was Y90-RE or systemic therapy) between the two cohorts. A total of 19 patients (10 atezolizumab/bevacizumab; 9 nivolumab), comprising 84% males with median age 69 years, met the inclusion criteria. Compared to the atezolizumab/bevacizumab group, there were less males (100% vs. 67%; = 0.02) and more ECOG ≥ 2 patients in the nivolumab group (0% vs. 33%; = 0.02). Baseline characteristics or incidence of 6-month post-treatment any-grade AE (60% vs. 56%; = 0.7), grade ≥ 3 AE (0% vs. 11%; = 0.3), objective response (58% total, 60% vs. 56%; = 0.7), and complete response (16% total; 10% vs. 22%; = 0.8) were similar between the atezolizumab/bevacizumab and the nivolumab cohorts. Median OS was 12.9 months for the whole cohort, 16.4 months for nivolumab, and 10.7 months for atezolizumab/bevacizumab. Among patients with advanced unresectable HCC, the utilization of Y90-RE concurrently or within 90 days of nivolumab or atezolizumab/bevacizumab immunotherapy, appears to be well-tolerated and with a low incidence of severe AE.

摘要

为了评估钇-90 放射性栓塞(Y90-RE)联合免疫检查点抑制剂治疗的安全性和有效性,回顾性评估了 2016 年至 2022 年间连续接受阿替利珠单抗/贝伐单抗或纳武利尤单抗治疗的、在 Y90-RE 治疗前 3 个月内和后 3 个月内进行免疫治疗的不可切除的晚期肝细胞癌(HCC)患者。在 1 个月和 6 个月时评估了肿瘤反应和治疗相关的临床/实验室不良事件(AE),并比较了两组之间初始治疗(无论是 Y90-RE 治疗还是系统治疗)之间的临床和实验室变量以及中位总生存期(OS)的差异。共有 19 名患者(10 名阿替利珠单抗/贝伐单抗;9 名纳武利尤单抗),包括 84%的男性,中位年龄为 69 岁,符合纳入标准。与阿替利珠单抗/贝伐单抗组相比,纳武利尤单抗组的男性比例较低(100%比 67%;=0.02),ECOG 评分≥2 的患者比例较高(0%比 33%;=0.02)。两组之间的 6 个月后任何级别治疗相关 AE 的发生率(60%比 56%;=0.7)、≥3 级 AE 的发生率(0%比 11%;=0.3)、客观缓解率(总缓解率 58%,60%比 56%;=0.7)和完全缓解率(总缓解率 16%,10%比 22%;=0.8)相似。整个队列的中位 OS 为 12.9 个月,纳武利尤单抗组为 16.4 个月,阿替利珠单抗/贝伐单抗组为 10.7 个月。在不可切除的晚期 HCC 患者中,Y90-RE 与 nivolumab 或 atezolizumab/bevacizumab 免疫治疗同时或在 90 天内使用似乎是可以耐受的,严重 AE 的发生率较低。

相似文献

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引用本文的文献

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Research trends of selective internal radiation therapy for liver cancer: a bibliometric analysis.

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[2]
The Evolving Application of Radiation Segmentectomy for the Treatment of Hepatic Malignancy.

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[3]
Advances and Emerging Techniques in Y-90 Radioembolization for Hepatocellular Carcinoma.

Cancers (Basel). 2025-4-29

[4]
Albi score predicts overall survival (OS) in patients with hepatocellular carcinoma (HCC) treated with selective internal radiation therapy (SIRT).

Radiol Med. 2025-2

[5]
New frontiers in radioembolization.

Ther Adv Med Oncol. 2024-9-30

[6]
The current status and future of targeted-immune combination for hepatocellular carcinoma.

Front Immunol. 2024

本文引用的文献

[1]
A Pilot Study of Pembrolizumab in Combination With Y90 Radioembolization in Subjects With Poor Prognosis Hepatocellular Carcinoma.

Oncologist. 2024-3-4

[2]
Tremelimumab plus Durvalumab in Unresectable Hepatocellular Carcinoma.

NEJM Evid. 2022-8

[3]
Combination of transarterial radioembolization with atezolizumab and bevacizumab for intermediate and advanced staged hepatocellular carcinoma: A preliminary report of safety and feasibility.

J Interv Med. 2023-9-28

[4]
Cancer Immunology: Impact of Radioembolization of Hepatocellular Carcinoma on Immune Response Modulation.

AJR Am J Roentgenol. 2023-6

[5]
Nivolumab after selective internal radiation therapy for the treatment of hepatocellular carcinoma: a phase 2, single-arm study.

J Immunother Cancer. 2022-11

[6]
Recent advances in systemic therapy for hepatocellular carcinoma.

Biomark Res. 2022-1-9

[7]
Updated efficacy and safety data from IMbrave150: Atezolizumab plus bevacizumab vs. sorafenib for unresectable hepatocellular carcinoma.

J Hepatol. 2022-4

[8]
BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update.

J Hepatol. 2022-3

[9]
Radioembolisation with Y90-resin microspheres followed by nivolumab for advanced hepatocellular carcinoma (CA 209-678): a single arm, single centre, phase 2 trial.

Lancet Gastroenterol Hepatol. 2021-12

[10]
Addressing the worldwide hepatocellular carcinoma: epidemiology, prevention and management.

J Gastrointest Oncol. 2021-7

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