Cancer Center, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.
World J Gastroenterol. 2024 Feb 28;30(8):843-854. doi: 10.3748/wjg.v30.i8.843.
Hepatocellular carcinoma (HCC) patients complicated with portal vein tumor thrombus (PVTT) exhibit poor prognoses and treatment responses.
To investigate efficacies and safety of the combination of PD-1 inhibitor, transcatheter arterial chemoembolization (TACE) and Lenvatinib in HCC subjects comorbid with PVTT.
From January 2019 to December 2020, HCC patients with PVTT types I-IV were retrospectively enrolled at Beijing Ditan Hospital. They were distributed to either the PTL or TACE/Lenvatinib (TL) group. The median progression-free survival (mPFS) was set as the primary endpoint, while parameters like median overall survival, objective response rate, disease control rate (DCR), and toxicity level served as secondary endpoints.
Forty-one eligible patients were finally recruited for this study and divided into the PTL ( = 18) and TL ( = 23) groups. For a median follow-up of 21.8 months, the DCRs were 88.9% and 60.9% in the PTL and TL groups ( = 0.046), res-pectively. Moreover, mPFS indicated significant improvement (HR = 0.25; < 0.001) in PTL-treated patients (5.4 months) compared to TL-treated (2.7 months) patients. There were no treatment-related deaths or differences in adverse events in either group.
A triplet regimen of PTL was safe and well-tolerated as well as exhibited favorable efficacy over the TL regimen for advanced-stage HCC patients with PVTT types I-IV.
肝细胞癌（HCC）合并门静脉癌栓（PVTT）的患者预后和治疗反应较差。
探讨 PD-1 抑制剂联合经导管动脉化疗栓塞（TACE）和仑伐替尼治疗合并 PVTT 的 HCC 患者的疗效和安全性。
回顾性纳入 2019 年 1 月至 2020 年 12 月在北京地坛医院就诊的 HCC 合并 PVTT Ⅰ-Ⅳ型患者，按治疗方案分为 TACE+培美曲塞组（PTL 组）和 TACE+仑伐替尼组（TL 组）。以中位无进展生存期（mPFS）为主要研究终点，以中位总生存期、客观缓解率（ORR）、疾病控制率（DCR）和毒性水平等为次要研究终点。
本研究共纳入 41 例患者，PTL 组 18 例，TL 组 23 例。中位随访时间为 21.8 个月，PTL 组和 TL 组的 DCR 分别为 88.9%和 60.9%（ = 0.046）。PTL 组 mPFS 为 5.4 个月，明显长于 TL 组的 2.7 个月（HR = 0.25； < 0.001）。两组均无治疗相关死亡和不良事件差异。
PTL 三联方案治疗 HCC 合并 PVTT Ⅰ-Ⅳ型患者安全、耐受良好，疗效优于 TL 方案。
