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度伐利尤单抗联合替西木单抗治疗不可切除肝细胞癌患者的肝功能变化。

Change in Liver Function in Durvalumab Plus Tremelimumab Treatment for Unresectable Hepatocellular Carcinoma.

机构信息

Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan.

Department of Gastroenterology Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, Hiroshima, Japan.

出版信息

Anticancer Res. 2024 Sep;44(9):3913-3918. doi: 10.21873/anticanres.17219.

Abstract

BACKGROUND/AIM: Maintaining liver function throughout the treatment of hepatocellular carcinoma (HCC) is crucial, yet the impact of durvalumab plus tremelimumab (DT) treatment on liver function is not well understood. This multicenter study aimed to examine the changes in liver function during DT treatment.

PATIENTS AND METHODS

This nationwide multicenter study included 80 patients who received DT treatment for unresectable HCC. The primary outcome was changes in albumin-bilirubin (ALBI) scores at baseline, week 8, week 12, and at the time of progressive disease (PD).

RESULTS

The median (interquartile range) ALBI scores at baseline, week 8, week 12, and the time of PD were -2.24 (-2.49 to -1.94), -2.13 (-2.51 to -1.86), -2.23 (-2.51 to - 1.77), and -2.06 (-2.53 to -1.72), respectively. No significant differences were observed at 8 weeks (p=0.06), at 12 weeks (p=0.4), and at PD (p=0.8) compared to baseline. Subgroup analyses were conducted for patients with an ALBI grade of 2 at baseline and for those who received DT treatment as a second-line or later treatment. No deterioration in liver function was observed at any time point in both analyses.

CONCLUSION

DT treatment can maintain liver function throughout the treatment period. Maintaining liver function is crucial in managing HCC, and this is an advantage of using DT treatment as a first-line treatment for unresectable HCC.

摘要

背景/目的:在治疗肝细胞癌(HCC)的过程中维持肝功能至关重要,但 durvalumab 联合 tremelimumab(DT)治疗对肝功能的影响尚不清楚。本多中心研究旨在研究 DT 治疗期间肝功能的变化。

患者和方法

本全国多中心研究纳入了 80 例接受 DT 治疗不可切除 HCC 的患者。主要结局是基线、第 8 周、第 12 周和疾病进展(PD)时白蛋白-胆红素(ALBI)评分的变化。

结果

基线、第 8 周、第 12 周和 PD 时的中位(四分位间距)ALBI 评分分别为-2.24(-2.49 至-1.94)、-2.13(-2.51 至-1.86)、-2.23(-2.51 至-1.77)和-2.06(-2.53 至-1.72)。与基线相比,第 8 周(p=0.06)、第 12 周(p=0.4)和 PD 时(p=0.8)无显著差异。对基线时 ALBI 分级为 2 的患者和接受 DT 治疗作为二线或以上治疗的患者进行了亚组分析。在这两种分析中,任何时间点均未观察到肝功能恶化。

结论

DT 治疗可在整个治疗期间维持肝功能。维持肝功能对于 HCC 的管理至关重要,这是将 DT 治疗作为不可切除 HCC 的一线治疗的优势之一。

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