Department of Medical Oncology, The First Affiliated Hospital of Bengbu Medical University, Bengbu, China.
Department of Oncology, Suzhou Hospital Affiliated to Anhui Medical University, Suzhou, China.
Ann Med. 2024 Dec;56(1):2393291. doi: 10.1080/07853890.2024.2393291. Epub 2024 Aug 21.
To present the real-world status and explore the predictors of the efficacy and prognosis of first-line treatment for unresectable hepatocellular carcinoma (uHCC).
Real-world data of uHCC patients who underwent first-line treatment at 4 hospitals in Northern Anhui, China, from July 2019 to December 2022 were retrospectively collected. The clinicopathological features, haematological indicators, including superoxide dismutase (SOD) and vascular endothelial growth factor-A (VEGF-A), efficacy and safety data were analysed.
A total of 153 patients were enrolled and most of them treated with targeted therapy combined with immunotherapy (TI). Compared to patients treated with TI, patients who were administrated with TI plus locoregional therapy (TIL) showed longer median progression-free survival (mPFS) and median overall survival (mOS) times (both < 0.05), with manageable safety profiles. Moreover, compared to patients with low baseline serum levels of SOD, patients with high baseline serum SOD levels had a better treatment efficacy and had longer mPFS and mOS times (all < 0.05). Subgroup analyses indicated that patients with low SOD levels had longer mPFS times when receiving TIL than when receiving TI ( 0.005), but, among patients with high SOD levels, their prognoses were not substantially different between TIL and TI ( > 0.05). Additionally, patients in the low-VEGF-A group had a longer mOS time than patients in the high-VEGF-A group ( = 0.004). In comparison with TI, TIL can improve the survival time among patients with high VEGF-A levels but not among patients with low VEGF-A levels.
TI was the most commonly first-line systemic therapy for uHCC patients, with better efficacy and outcomes when combined with locoregional therapy in a certain population. Baseline serum SOD and VEGF-A were found to be potential predictive biomarkers for decision-making, treatment response, and outcome in patients with uHCC in the primary care setting.
介绍不可切除肝细胞癌（uHCC）一线治疗的实际状况，并探讨疗效和预后的预测因素。
回顾性收集了 2019 年 7 月至 2022 年 12 月在中国皖北 4 家医院接受一线治疗的 uHCC 患者的真实世界数据。分析了临床病理特征、血液学指标（包括超氧化物歧化酶[SOD]和血管内皮生长因子-A[VEGF-A]）、疗效和安全性数据。
共纳入 153 例患者，其中大多数接受靶向治疗联合免疫治疗（TI）。与接受 TI 治疗的患者相比，接受 TI 加局部区域治疗（TIL）的患者中位无进展生存期（mPFS）和中位总生存期（mOS）更长（均<0.05），且安全性可控。此外，与基线血清 SOD 水平较低的患者相比，基线血清 SOD 水平较高的患者治疗效果更好，mPFS 和 mOS 时间更长（均<0.05）。亚组分析表明，SOD 水平较低的患者接受 TIL 治疗时的 mPFS 时间长于接受 TI 治疗时（P=0.005），但 SOD 水平较高的患者中，TIL 和 TI 治疗的预后差异无统计学意义（P>0.05）。此外，VEGF-A 水平较低的患者的 mOS 时间长于 VEGF-A 水平较高的患者（P=0.004）。与 TI 相比，TIL 可延长某些人群中高 VEGF-A 水平患者的生存时间，但对低 VEGF-A 水平患者无明显影响。
TI 是 uHCC 患者最常用的一线系统治疗方法，在特定人群中与局部区域治疗联合应用时疗效和结局更好。基线血清 SOD 和 VEGF-A 被发现是基层医疗机构中 uHCC 患者决策、治疗反应和结局的潜在预测生物标志物。
