Sun Sha-Sha, Guo Xiao-Di, Li Wen-Dong, Chen Jing-Long
Department of Oncology, Capital Medical University Affiliated Beijing Ditan Hospital, Beijing 100015, China.
World J Clin Cases. 2024 Jan 16;12(2):285-292. doi: 10.12998/wjcc.v12.i2.285.
Recently, combination therapy has shown a better trend towards improved tumour response and survival outcomes than monotherapy in patients with hepatocellular carcinoma (HCC). However, research on triple therapy [lenvatinib + sintilimab + transarterial chemoembolization (TACE)] as a first-line treatment for advanced HCC is limited.
To evaluate the safety and efficacy of triple therapy as a first-line treatment for advanced HCC.
HCC patients with Barcelona Clinic Liver Cancer stage C treated with triple therapy were enrolled. All patients were treated with lenvatinib every day and sintilimab once every 3 wk. Moreover, TACE was performed every 4-6 wk if necessary. The primary outcome of the study was overall survival (OS). The secondary outcomes were the objective response rate (ORR), disease control rate (DCR), and incidence of adverse events.
Forty HCC patients who underwent triple therapy were retrospectively analysed from January 2019 to January 2022. With a median follow-up of 8.5 months, the 3-, 6-, and 12-mo OS rates were 100%, 88.5%, and 22.5%, respectively. The ORR and DCR were 45% and 90%, respectively. The median progressive free survival and median OS were not reached. Common complications were observed in 76% of the patients (grade 3, 15%; grade 4, 2.5%).
Combination therapy comprising lenvatinib, sintilimab and TACE achieved promising outcomes in advanced HCC patients and had manageable effects.
最近，在肝细胞癌（HCC）患者中，联合治疗比单一疗法在改善肿瘤反应和生存结果方面显示出更好的趋势。然而，关于三联疗法[乐伐替尼+信迪利单抗+经动脉化疗栓塞术（TACE）]作为晚期HCC一线治疗的研究有限。
评估三联疗法作为晚期HCC一线治疗的安全性和疗效。
纳入接受三联疗法治疗的巴塞罗那临床肝癌C期HCC患者。所有患者每天服用乐伐替尼，信迪利单抗每3周给药一次。此外，必要时每4 - 6周进行一次TACE。该研究的主要结局是总生存期（OS）。次要结局是客观缓解率（ORR）、疾病控制率（DCR）和不良事件发生率。
回顾性分析了2019年1月至2022年1月接受三联疗法的40例HCC患者。中位随访8.5个月，3个月、6个月和12个月的OS率分别为100%、88.5%和22.5%。ORR和DCR分别为45%和90%。中位无进展生存期和中位OS未达到。76%的患者观察到常见并发症（3级，15%；4级，2.5%）。
乐伐替尼、信迪利单抗和TACE组成的联合疗法在晚期HCC患者中取得了有前景的结果，且效果可控。
