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PD-1联合瑞戈非尼治疗晚期肝细胞癌的疗效与安全性分析

Efficacy and safety analysis of PD-1 combined with regorafenib in the treatment of advanced hepatocellular carcinoma.

作者信息

Dong Lu, Wang Pengbin, Pan Yan, Sun Naiying, Yin Gang

机构信息

Gastroenterology Department, Lanzhou Petrochemical General Hospital (The Fourth Affiliated Hospital of Gansu University of Traditional Chinese Medicine) No. 733 Fuli West Road, Xigu District, Lanzhou 730060, Gansu, China.

Gastroenterology Department, The Second People's Hospital of Lanzhou City No. 388 Jingyuan Road, Chengguan District, Lanzhou 730060, Gansu, China.

出版信息

Am J Transl Res. 2024 Jun 15;16(6):2554-2562. doi: 10.62347/IIHG2242. eCollection 2024.

Abstract

OBJECTIVE

To investigate the therapeutic efficacy and safety of programmed death-1 (PD-1) inhibitors combined with regorafenib in the treatment of advanced hepatocellular carcinoma (HCC).

METHODS

A retrospective analysis was performed on 82 patients diagnosed with advanced HCC at Lanzhou Petrochemical General Hospital and the Second People's Hospital of Lanzhou City from October 2021 to October 2022. Patients were divided into two groups: the observation group (42 patients) received combined therapy with regorafenib and a PD-1 inhibitor, while the control group (40 patients) received only regorafenib monotherapy. Treatment efficacy, changes in serum tumor markers pre- and post-treatment, incidence of adverse reactions, progression-free survival (PFS), 1-year survival rate, and independent prognostic factors were evaluated for both groups.

RESULTS

The treatment efficacy in the observation group was significantly better than that in the control group (P<0.05). Post-treatment levels of VEGF, sIL-2R, and CEA were significantly lower in the observation group compared to the control group (all P<0.05). The incidence of adverse reactions was similar between the two groups (P>0.05). However, the observation group demonstrated a significantly higher median PFS and 1-year survival rate than the control group (both P<0.05). Vascular invasion, degree of differentiation, and treatment regimen were identified as independent prognostic factors affecting outcomes (all P<0.05).

CONCLUSION

For patients with advanced HCC, integrating PD-1 inhibitors with regorafenib treatment not only enhances clinical efficacy but also maintains safety. This combination therapy significantly improves progression-free survival and 1-year survival rates, supporting its further clinical application.

摘要

目的

探讨程序性死亡受体1(PD-1)抑制剂联合瑞戈非尼治疗晚期肝细胞癌(HCC)的疗效及安全性。

方法

对2021年10月至2022年10月在兰州石化总医院和兰州市第二人民医院确诊为晚期HCC的82例患者进行回顾性分析。患者分为两组:观察组(42例)接受瑞戈非尼与PD-1抑制剂联合治疗,对照组(40例)仅接受瑞戈非尼单药治疗。评估两组的治疗效果、治疗前后血清肿瘤标志物变化、不良反应发生率、无进展生存期(PFS)、1年生存率及独立预后因素。

结果

观察组治疗效果显著优于对照组(P<0.05)。观察组治疗后VEGF、sIL-2R和CEA水平显著低于对照组(均P<0.05)。两组不良反应发生率相似(P>0.05)。然而,观察组的中位PFS和1年生存率显著高于对照组(均P<0.05)。血管侵犯、分化程度和治疗方案被确定为影响预后的独立预后因素(均P<0.05)。

结论

对于晚期HCC患者,PD-1抑制剂与瑞戈非尼联合治疗不仅提高临床疗效,且安全性良好。这种联合治疗显著提高无进展生存期和1年生存率,支持其进一步临床应用。

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