Department of Hepatobiliary Surgery, Affiliated Hospital of Hebei University, Baoding, 07100, China.
J Cancer Res Clin Oncol. 2024 Jul 8;150(7):340. doi: 10.1007/s00432-024-05854-8.
The evidence of apatinib plus immune checkpoint inhibitors (ICIs) and transarterial chemoembolization (TACE) for treating advanced hepatocellular carcinoma (HCC) is limited. This study aimed to compare the treatment efficacy and safety of apatinib plus ICIs and TACE with apatinib plus TACE in these patients.
This study retrospectively enrolled 90 patients with advanced HCC treated with apatinib plus TACE (A-TACE group, n = 52) or apatinib plus ICIs and TACE (IA-TACE group, n = 38).
The objective response rate was numerically higher in IA-TACE group compared with A-TACE group without statistical significance (57.9% vs. 36.5%, P = 0.055). Disease control rate was not different between groups (86.8% vs. 76.9%, P = 0.248). Progression-free survival (PFS) was improved in IA-TACE group compared with A-TACE group (P = 0.018). The median PFS (95% confidence interval) was 12.5 (8.7-16.3) months in IA-TACE group and 8.5 (5.6-11.4) months in A-TACE group. Overall survival (OS) was also prolonged in IA-TACE group compared with A-TACE group (P = 0.007). The median OS (95% confidence interval) was 21.1 (15.8-26.4) months in IA-TACE group and 14.3 (11.5-17.1) months in A-TACE group. By multivariate Cox regression model, IA-TACE was independently associated with prolonged PFS (hazard ratio = 0.539, P = 0.038) and OS (hazard ratio = 0.447, P = 0.025). Most adverse events were not different between groups. Only the incidence of reactive cutaneous capillary endothelial proliferation was higher in IA-TACE group compared with A-TACE group (10.5% vs. 0.0%, P = 0.029).
Apatinib plus ICIs and TACE may be an effective and safe treatment for patients with advanced HCC, but further large-scale studies are needed for verification.
阿帕替尼联合免疫检查点抑制剂（ICI）和经动脉化疗栓塞（TACE）治疗晚期肝细胞癌（HCC）的证据有限。本研究旨在比较阿帕替尼联合 ICI 和 TACE 与阿帕替尼联合 TACE 治疗这些患者的疗效和安全性。
本研究回顾性纳入 90 例接受阿帕替尼联合 TACE（A-TACE 组，n=52）或阿帕替尼联合 ICI 和 TACE（IA-TACE 组，n=38）治疗的晚期 HCC 患者。
IA-TACE 组客观缓解率（ORR）高于 A-TACE 组，但无统计学意义（57.9% vs. 36.5%，P=0.055）。两组疾病控制率（DCR）无差异（86.8% vs. 76.9%，P=0.248）。IA-TACE 组无进展生存期（PFS）优于 A-TACE 组（P=0.018）。IA-TACE 组的中位 PFS（95%置信区间）为 12.5（8.7-16.3）个月，A-TACE 组为 8.5（5.6-11.4）个月。IA-TACE 组总生存期（OS）也优于 A-TACE 组（P=0.007）。IA-TACE 组的中位 OS（95%置信区间）为 21.1（15.8-26.4）个月，A-TACE 组为 14.3（11.5-17.1）个月。多变量 Cox 回归模型显示，IA-TACE 与 PFS（风险比=0.539，P=0.038）和 OS（风险比=0.447，P=0.025）的延长独立相关。两组间大多数不良反应无差异。仅 IA-TACE 组反应性皮肤毛细血管内皮增殖的发生率高于 A-TACE 组（10.5% vs. 0.0%，P=0.029）。
阿帕替尼联合 ICI 和 TACE 可能是治疗晚期 HCC 的有效且安全的方法，但需要进一步的大规模研究来验证。
