Du Qi, Yuan Jia, Ren Zhenggang
Liver Cancer Institute, Zhongshan Hospital, Fudan University and National Clinical Research Center for Interventional Medicine, Shanghai, China.
Liver Cancer. 2023 Oct 30;13(4):344-354. doi: 10.1159/000534446. eCollection 2024 Aug.
BACKGROUND: Immune checkpoint inhibitors (ICIs) have demonstrated effectiveness for advanced hepatocellular carcinoma (HCC). However, the discrepancy in the efficacy of ICIs in HCC patients with distinct etiologies has not been systematically validated. METHODS: PubMed, MEDLINE, Embase, clinicaltrials.gov, and abstracts from ASCO and ESMO conferences were searched for eligible trials that explored the impact of etiology factor on the ICI treatment in HCC patients. The pooled hazard ratio (HR) of overall survival (OS) and progression-free survival (PFS), as well as the pooled odds ratio (OR) of objective response rate (ORR), were calculated with stratification of hepatitis B virus (HBV), hepatitis C virus (HCV) and nonviral subgroup, and the heterogeneity between different etiological subgroups was assessed by using an interaction test. RESULTS: Eight eligible studies with a total of 5,646 patients were identified from searching published articles and conference abstracts. ICI therapies were associated with significantly prolonged OS with the pooled HRs of 0.78 (95% CI 0.73-0.84, < 0.001), 0.71 (95% CI 0.65-0.79, < 0.001), 0.80 (95% CI 0.69-0.93, = 0.003), and 0.87 (95% CI 0.77-0.97, = 0.011) for the whole population, HBV subgroup, HCV subgroup, and non-viral subgroup, respectively. In addition, this analysis reported a significant PFS improvement with ICI therapies with HRs of 0.78 ( = 0.004), 0.53 ( < 0.001), 0.65 ( = 0.011), and 0.81 ( = 0.107) for whole population, HBV, HCV, and nonviral subgroup, respectively. The HBV-related HCC patients showed the more distinctive HRs for OS and PFS than other etiology subgroups, and this difference was significant in PFS ( for heterogeneity = 0.001), and there was a tendency of significance in OS ( for heterogeneity = 0.079). Furthermore, the ORR advantages of ICI therapies over control were also confirmed with the pooled ORs of 3.62 ( < 0.001), 3.84 ( < 0.001), 3.05 ( < 0.001), and 2.99 ( < 0.001) for whole population, HBV, HCV, and nonviral population, respectively ( for heterogeneity = 0.743). CONCLUSIONS: ICI therapies significantly improve OS, PFS, and ORR for HCC patients with different etiologies. HBV-related HCC patients could be the highlighted population to benefit from ICI treatment.
背景：免疫检查点抑制剂（ICIs）已被证明对晚期肝细胞癌（HCC）有效。然而，ICIs在不同病因的HCC患者中的疗效差异尚未得到系统验证。 方法：检索PubMed、MEDLINE、Embase、clinicaltrials.gov以及美国临床肿瘤学会（ASCO）和欧洲肿瘤内科学会（ESMO）会议的摘要，以寻找探索病因因素对HCC患者ICI治疗影响的符合条件的试验。计算总生存期（OS）和无进展生存期（PFS）的合并风险比（HR），以及客观缓解率（ORR）的合并比值比（OR），并按乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）和非病毒亚组进行分层，使用交互检验评估不同病因亚组之间的异质性。 结果：通过检索已发表文章和会议摘要，确定了8项符合条件的研究，共5646例患者。ICI治疗与显著延长的OS相关，全人群、HBV亚组、HCV亚组和非病毒亚组的合并HR分别为0.78（95%CI 0.73 - 0.84，P < 0.001）、0.71（95%CI 0.65 - 0.79，P < 0.001）、0.80（95%CI 0.69 - 0.93，P = 0.003）和0.87（95%CI 0.77 - 0.97，P = 0.011）。此外，该分析报告ICI治疗使PFS显著改善，全人群、HBV、HCV和非病毒亚组的HR分别为0.78（P = 0.004）、0.53（P < 0.001）、0.65（P = 0.011）和0.81（P = 0.107）。与HBV相关的HCC患者在OS和PFS方面显示出比其他病因亚组更显著的HR，且这种差异在PFS中具有显著性（异质性P = 0.001），在OS中存在显著性趋势（异质性P = 0.079）。此外，ICI治疗相对于对照的ORR优势也得到证实，全人群、HBV、HCV和非病毒人群的合并OR分别为3.62（P < 0.001）、3.84（P < 0.001）、3.05（P < 0.001）和2.99（P < 0.001）（异质性P = 0.743）。 结论：ICI治疗显著改善了不同病因的HCC患者的OS、PFS和ORR。与HBV相关的HCC患者可能是从ICI治疗中获益的突出人群。
NPJ Biofilms Microbiomes. 2025-9-2
Anticancer Agents Med Chem. 2025
Nat Rev Clin Oncol. 2022-3
Semin Liver Dis. 2021-5
Zotero 插件
