经导管动脉化疗栓塞术联合索拉非尼与经导管动脉化疗栓塞术联合仑伐替尼治疗中期肝细胞癌。

Transcatheter arterial chemoembolization plus Sorafenib versus transcatheter arterial chemoembolization plus Lenvatinib for intermediate hepatocellular carcinoma.

机构信息

Department of Respiratory, The Eighth Medical Center of Chinese PLA General Hospital, Beijing, 100091, China.

Senior Department of Hepatology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100853, China.

出版信息

Sci Rep. 2024 Oct 27;14(1):25616. doi: 10.1038/s41598-024-74801-x.

BACKGROUND

Recent studies have highlighted that TACE in conjunction with Lenvatinib (TACE-L) offers a promising adjunct therapy for advanced HCC patients, outperforming TACE plus Sorafenib (TACE-S). However, there has been a lack of research comparing these two regimens for intermediate HCC.

AIMS

This study aims to address the research gap by evaluating the efficacy of TACE-L versus TACE-S in intermediate HCC patients.

METHODS

A retrospective analysis was conducted on a cohort of consecutive intermediate HCC patients who received either TACE-L or TACE-S from November 2018 to December 2022. Portal vein width was assessed using abdominal NMRI or Doppler ultrasonography, and inflammatory markers were derived from routine blood counts. The primary outcomes of interest were overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and adverse drug reactions (ADRs).

RESULTS

The study included 117 patients, with 56 in the TACE-S group and 61 in the TACE-L group. The TACE-S group demonstrated superior OS (HR = 1.704, 95% CI: 1.012-2.870, p = 0.045) compared to the TACE-L group. No significant difference was observed in PFS (HR:1.512, 95% CI: 0.988-2.313, p = 0.057) between the two groups. Subgroup analyses revealed that male patients, those with cirrhosis, and those with more than four tumors had better OS and PFS in the TACE-S group than in the TACE-L group. Inflammatory markers were comparable between the groups. The TACE-S group experienced a higher incidence of palmar-plantar erythrodysesthesia syndrome (PPE) (14/56 [25%] vs. 5/61 [8.1%], p = 0.014) but a lower incidence of hypertension (3/56 [5.3%] vs. 11/61 [18%], p = 0.035) compared to the TACE-L group.

CONCLUSIONS

In patients with intermediate HCC, TACE-S was found to be more effective in terms of OS than TACE-L. No significant disparity was noted in PFS between the two treatment groups.

背景

最近的研究强调，TACE 联合仑伐替尼（TACE-L）为晚期 HCC 患者提供了一种很有前途的辅助治疗方法，优于 TACE 联合索拉非尼（TACE-S）。然而，对于中晚期 HCC，还缺乏这两种方案的比较研究。

目的

本研究旨在通过评估 TACE-L 与 TACE-S 治疗中晚期 HCC 患者的疗效来填补这一研究空白。

方法

对 2018 年 11 月至 2022 年 12 月期间接受 TACE-L 或 TACE-S 治疗的连续中晚期 HCC 患者队列进行回顾性分析。门静脉宽度采用腹部 NMRI 或多普勒超声检查评估，炎症标志物源自常规血常规。主要观察终点为总生存期（OS）、无进展生存期（PFS）、客观缓解率（ORR）、疾病控制率（DCR）和药物不良反应（ADR）。

结果

研究纳入了 117 例患者，其中 TACE-S 组 56 例，TACE-L 组 61 例。TACE-S 组的 OS 优于 TACE-L 组（HR=1.704，95%CI：1.012-2.870，p=0.045）。两组之间 PFS 无显著差异（HR：1.512，95%CI：0.988-2.313，p=0.057）。亚组分析显示，男性患者、肝硬化患者和肿瘤数多于四个的患者，TACE-S 组的 OS 和 PFS 优于 TACE-L 组。两组之间的炎症标志物相似。TACE-S 组手足皮肤反应综合征（PPE）的发生率更高（14/56[25%]比 5/61[8.1%]，p=0.014），而高血压的发生率更低（3/56[5.3%]比 11/61[18%]，p=0.035）。