Cai Hongjie, Chen Song, Wu Zhiqiang, Wang Fan, Tang Shuangyan, Chen Ludan, Guo Wenbo
Department of Interventional Radiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510062, People's Republic of China.
Department of Minimally Invasive Interventional Therapy, Sun Yat-Sen University Cancer Center and Sun Yat-Sen University State Key Laboratory of Oncology in South China, and Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China.
J Hepatocell Carcinoma. 2024 Feb 26;11:399-409. doi: 10.2147/JHC.S439001. eCollection 2024.
Local in combination with systemic therapy might be an option for patients with advanced unresectable hepatocellular carcinoma (uHCC). This study examined the clinical benefits and adverse events (AEs) of first-line transarterial embolization (TAE) and hepatic arterial infusion chemotherapy (HAIC) combined with atezolizumab (Atezo) and bevacizumab (Bev) in patients with uHCC of a diameter larger than 8 cm.
This retrospective study included patients with uHCC of a diameter larger than 8 cm who were treated with first-line Atezo-Bev and TAE+HAIC at the First Affiliated Hospital of Sun Yat-Sen University between September 30, 2019, and September 30, 2022. Progression-free survival (PFS), overall survival (OS), tumor response according to mRECIST, and AEs were analyzed. Multivariable Cox analyses were performed to examine the factors associated with PFS.
Thirty patients were included. The objective response rate (ORR) was 74.4% (95% confidence interval [CI], 59.3%-89.5%), and the disease control rate (DCR) was 93.3% (95% CI, 85.4%-98.6%). The median follow-up was 11.4 (inter-quartile range [IQR], 5.5-17.9) months. The median PFS was 6.8 (95% CI, 2.6-11.1) months. The 3-, 6-, 9-, and 12-month survival rates were 86.2%, 82.5%, 68.6%, and 60%, respectively. The median OS was not estimated. Extrahepatic metastasis was independently associated with PFS (hazard ratio [HR]=3.468, 95% CI, 1.001-12.023). The most common AEs were fever (46.7%). Grade 4 AEs occurred one time as hematemesis but no 5 AEs were observed.
Atezo-Bev combined with TAE and HAIC might benefit patients with uHCC of a diameter larger than 8 cm, with manageable AEs.
对于无法切除的晚期肝细胞癌（uHCC）患者，局部治疗联合全身治疗可能是一种选择。本研究探讨了一线经动脉栓塞（TAE）和肝动脉灌注化疗（HAIC）联合阿替利珠单抗（Atezo）和贝伐珠单抗（Bev）治疗直径大于8 cm的uHCC患者的临床疗效和不良事件（AE）。
本回顾性研究纳入了2019年9月30日至2022年9月30日期间在中山大学附属第一医院接受一线Atezo-Bev和TAE+HAIC治疗的直径大于8 cm的uHCC患者。分析无进展生存期（PFS）、总生存期（OS）、根据改良RECIST标准评估的肿瘤反应以及AE。进行多变量Cox分析以检查与PFS相关的因素。
共纳入30例患者。客观缓解率（ORR）为74.4%（95%置信区间[CI]，59.3%-89.5%），疾病控制率（DCR）为93.3%（95%CI，85.4%-98.6%）。中位随访时间为11.4（四分位间距[IQR]，5.5-17.9）个月。中位PFS为6.8（95%CI，2.6-11.1）个月。3个月、6个月、9个月和12个月生存率分别为86.2%、82.5%、68.6%和60%。未估计中位OS。肝外转移与PFS独立相关（风险比[HR]=3.468，95%CI，1.001-12.023）。最常见的AE是发热（46.7%）。4级AE发生1次，为呕血，但未观察到5级AE。
Atezo-Bev联合TAE和HAIC可能使直径大于8 cm的uHCC患者获益，且AE可控。
