State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, China.
Department of Liver Surgery, Sun Yat-Sen University Cancer Center, Guangzhou, China.
Clin Exp Med. 2024 Jun 28;24(1):138. doi: 10.1007/s10238-024-01415-y.
Both atezolizumab (a PD-L1 inhibitor) plus bevacizumab (A+B) and sintilimab (a PD-1 inhibitor) plus bevacizumab (S+B) are recommended as the first-line regimen for advanced hepatocellular carcinoma (HCC) in China. Different efficacy between the two regimens combined with transvascular intervention for unresectable HCC (uHCC) remain unknown. We retrospectively analyzed uHCC patients treated in three centers by simultaneous combination of A+B or S+B with transarterial chemoembolization (TACE) and FOLFOX-based hepatic arterial infusion chemotherapy (HAIC). Objective response rate (ORR), progression-free survival (PFS), overall survival (OS) and treatment-related adverse events (TRAEs) were compared. Totally 188 patients were included, with 92 and 96 administered A+B+TACE-HAIC (ABTH) and S+B+TACE-HAIC (SBTH), respectively. ORRs (62.0 vs. 70.8%, respectively; P = 0.257) and disease control rates (88.0 vs. 93.8%, P = 0.267) were similar between groups by the mRECIST criteria. ABTH showed no survival advantage over SBTH, with median PFS times of 11.7 months and 13.0 months, respectively (HR = 0.81, 95% CI, 0.52-1.26, P = 0.35) and similar OS times (HR = 1.19, 95% CI, 0.32-4.39, P = 0.8). No significant differences were observed in grade 3-4 TRAEs between groups. Either PD-L1 or PD-1 inhibitor plus bevacizumab combined with TACE-HAIC have similarly excellent therapeutic efficacy with manageable adverse events, representing promising treatment options for uHCC.
阿替利珠单抗（PD-L1 抑制剂）联合贝伐珠单抗（A+B）和信迪利单抗（PD-1 抑制剂）联合贝伐珠单抗（S+B）均被推荐为中国晚期肝细胞癌（HCC）的一线治疗方案。两种方案联合经血管介入治疗不可切除 HCC（uHCC）的疗效尚不清楚。我们回顾性分析了三个中心的 uHCC 患者，这些患者同时接受 A+B 或 S+B 联合经动脉化疗栓塞（TACE）和基于氟尿嘧啶、奥沙利铂的肝动脉灌注化疗（HAIC）治疗。比较客观缓解率（ORR）、无进展生存期（PFS）、总生存期（OS）和治疗相关不良反应（TRAEs）。共纳入 188 例患者，其中 92 例和 96 例分别接受 A+B+TACE-HAIC（ABTH）和 S+B+TACE-HAIC（SBTH）治疗。根据 mRECIST 标准，两组的 ORR（分别为 62.0%和 70.8%；P=0.257）和疾病控制率（分别为 88.0%和 93.8%；P=0.267）相似。ABTH 组与 SBTH 组相比，PFS 时间分别为 11.7 个月和 13.0 个月，中位 OS 时间分别为 11.7 个月和 13.0 个月（HR=0.81，95%CI：0.52-1.26，P=0.35）和相似（HR=1.19，95%CI：0.32-4.39，P=0.8）。两组 3-4 级 TRAEs 发生率无显著差异。PD-L1 或 PD-1 抑制剂联合贝伐珠单抗联合 TACE-HAIC 具有相似的优异疗效和可管理的不良反应，是 uHCC 有前途的治疗选择。
