经导管动脉化疗栓塞联合卡瑞利珠单抗治疗复发性肝细胞癌。
Transarterial chemoembolization with molecular targeted therapies plus camrelizumab for recurrent hepatocellular carcinoma.
机构信息
Department of Intervention, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, 107# Huanhu East Road, Shushan District, 230031, Hefei, Anhui, People's Republic of China.
Graduate School of Bengbu Medical College, Bengbu, Anhui, China.
出版信息
BMC Cancer. 2024 Mar 27;24(1):387. doi: 10.1186/s12885-024-12144-6.
BACKGROUND
The safety and efficacy of transarterial chemoembolization plus molecular targeted therapy (MTT) combined with immune checkpoint inhibitors (ICIs) in primary liver cancer have been demonstrated. However, the evidence for TACE plus MTT combined with ICIs in the treatment of recurrent hepatocellular carcinoma (RHCC) is limited. Given the excellent performance of this combination regimen in primary liver cancer, it is necessary to evaluate the efficacy of TACE plus MTT combined with ICIs in RHCC.
METHODS
A total of 88 patients with RHCC treated with TACE plus MTT combined with camrelizumab (TACE-TC group, n = 46) or TACE plus MTT (TACE-T group, n = 42) were retrospectively collected and analyzed. In this study, we evaluated the effectiveness and safety of combination therapy for patients with RHCC by analyzing tumor response, progression-free survival (PFS), overall survival (OS), laboratory biochemical indices, and adverse events (AEs).
RESULTS
TACE-TC was superior to TACE-T in PFS (14.0 vs. 8.9 months, p = 0.034) and OS (31.1 vs. 20.2 months, p = 0.009). Moreover, TACE-TC achieved more preferable benefits with respect to disease control rate (89.1% vs. 71.4%, p = 0.036) and objective response rate (47.8% vs. 26.2%, p = 0.036) compared with TACE-T in patients with RHCC. Compared with the TACE-T group, the AFP level in the TACE-TC group decreased more significantly after 3 months of treatment. Multivariate analysis showed that treatment option was a significant predictor of OS and PFS, while the portal vein tumor thrombus and interval of recurrence from initial treatment were another prognostic factor of PFS. There was no significant difference between the TACE-TC and TACE-T groups for Grade 3-4 adverse events.
CONCLUSIONS
A combination therapy of TACE, MTT, and camrelizumab significantly improved tumor response and prolonged survival duration, showing a better survival prognosis for RHCC patients.
背景
经动脉化疗栓塞术（TACE）联合分子靶向治疗（MTT）加免疫检查点抑制剂（ICI）在原发性肝癌中的安全性和有效性已得到证实。然而，TACE 联合 MTT 加 ICI 治疗复发性肝细胞癌（RHCC）的证据有限。鉴于该联合方案在原发性肝癌中的优异表现，有必要评估 TACE 联合 MTT 加 ICI 在 RHCC 中的疗效。
方法
回顾性收集并分析了 88 例接受 TACE 联合 MTT 加卡瑞利珠单抗（TACE-TC 组，n=46）或 TACE 联合 MTT（TACE-T 组，n=42）治疗的 RHCC 患者。本研究通过分析肿瘤反应、无进展生存期（PFS）、总生存期（OS）、实验室生化指标和不良事件（AE），评估联合治疗 RHCC 患者的有效性和安全性。
结果
TACE-TC 组的 PFS（14.0 个月比 8.9 个月，p=0.034）和 OS（31.1 个月比 20.2 个月，p=0.009）均优于 TACE-T 组。此外，与 TACE-T 组相比，TACE-TC 组在 RHCC 患者中获得了更高的疾病控制率（89.1%比 71.4%，p=0.036）和客观缓解率（47.8%比 26.2%，p=0.036）。与 TACE-T 组相比，TACE-TC 组治疗 3 个月后 AFP 水平下降更明显。多因素分析显示，治疗方案是 OS 和 PFS 的显著预测因素，而门静脉癌栓和初始治疗后复发间隔是 PFS 的另一个预后因素。TACE-TC 组和 TACE-T 组 3-4 级不良事件无显著差异。
结论
TACE、MTT 和卡瑞利珠单抗联合治疗显著提高了肿瘤反应，延长了生存时间，为 RHCC 患者带来了更好的生存预后。
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