经倾向性评分匹配研究：TACE 联合仑伐替尼加卡瑞利珠单抗对比 TACE 单药治疗不可切除肝细胞癌的疗效和安全性。

TACE combined Lenvatinib plus Camrelizumab versus TACE alone in efficacy and safety for unresectable hepatocellular carcinoma: a propensity score-matching study.

机构信息

Department of Hepatobiliarypancreatic-Splenic Surgery, Guangxi Medical University Cancer Hospital, Nanning, China.

Hepatobiliary Surgery Department, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China.

出版信息

BMC Cancer. 2024 Jun 11;24(1):717. doi: 10.1186/s12885-024-12484-3.

DOI:10.1186/s12885-024-12484-3

PMID:38862932

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11165855/

Abstract

BACKGROUNDS

To compare the efficacy and safety of transcatheter arterial chemoembolization (TACE) combined Lenvatinib plus Camrelizumab (TLC) in unresectable hepatocellular carcinoma (uHCC) with those of TACE alone .

METHODS

A retrospective analysis was performed on 222 patients with uHCC who were treated between September 2013 and Jun 2023. One group received TACE + lenvatinib + camrelizumab (TLC) (n = 97) and another group received TACE alone (n = 151). Efficacy and safety were compared after propensity score matching between the TLC and TACE groups.

RESULTS

After propensity matching, the TLC group had higher objective response rate (ORR) (88.6% vs. 28.6%, P < 0.001), disease control rate (DCR) (94.3%% vs. 72.9%, P < 0.001), and conversion rates before and after propensity matching were 44.1% and 41.4%, respectively, compared with the TACE group. The median progression free survival (PFS) was longer in the TLC group than in the TACE group (12.7 vs. 6.1 months, P = 0.005). The median overall survival (OS) was longer in the TLC group than in the TACE group (19.4 vs. 13.0 months, P = 0.023). Cox multivariate analysis with different modes of adjustment showed that treatment was an independent influencing factor of PFS and OS. The interaction analysis showed that cirrhosis and Child-Pugh stage an interactive role in the PFS of different treatment. Decreased AFP after treatment portends higher ORR and DCR.

CONCLUSION

TACE combined Lenvatinib plus Camrelizumab regimen was safe and superior to TACE alone in improving PFS, OS, and tumor response rates for unresectable recurrent HCC patients.

摘要

背景

比较经导管动脉化疗栓塞术（TACE）联合仑伐替尼加卡瑞利珠单抗（TLC）与单纯 TACE 治疗不可切除肝细胞癌（uHCC）的疗效和安全性。

方法

对 2013 年 9 月至 2023 年 6 月期间接受治疗的 222 例 uHCC 患者进行回顾性分析。一组接受 TACE+仑伐替尼+卡瑞利珠单抗（TLC）（n=97），另一组接受单纯 TACE（n=151）。在 TLC 和 TACE 组之间进行倾向评分匹配后，比较疗效和安全性。

结果

在倾向评分匹配后，TLC 组客观缓解率（ORR）（88.6% vs. 28.6%，P<0.001）、疾病控制率（DCR）（94.3% vs. 72.9%，P<0.001）较高，且转化率分别为 44.1%和 41.4%，高于 TACE 组。TLC 组无进展生存期（PFS）长于 TACE 组（12.7 个月 vs. 6.1 个月，P=0.005）。TLC 组总生存期（OS）长于 TACE 组（19.4 个月 vs. 13.0 个月，P=0.023）。不同调整模式的 Cox 多变量分析显示，治疗是 PFS 和 OS 的独立影响因素。交互分析显示，肝硬化和 Child-Pugh 分期在不同治疗方式的 PFS 中具有交互作用。治疗后 AFP 降低预示着更高的 ORR 和 DCR。