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仑伐替尼、信迪利单抗联合介入治疗 贝伐珠单抗、信迪利单抗联合介入治疗中晚期不可切除肝细胞癌。

Lenvatinib, sintilimab combined interventional treatment bevacizumab, sintilimab combined interventional treatment for intermediate-advanced unresectable hepatocellular carcinoma.

机构信息

Department of Hepatobiliary Cancer, Liver Cancer Center, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Key Laboratory of Digestive Cancer, Tianjin 300060, China.

Department of Hepatobiliary Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

出版信息

World J Gastroenterol. 2024 Nov 21;30(43):4620-4635. doi: 10.3748/wjg.v30.i43.4620.

Abstract

BACKGROUND

Bevacizumab and sintilimab combined interventional treatment (BeSiIT) and L envatinib and sintilimab combined interventional treatment (LeSiIT) are two commonly used therapeutic regimens for intermediate-advanced hepatocellular carcinoma (HCC) in clinical practice.

AIM

To compare the clinical efficacy and safety of BeSiIT and LeSiIT for the treatment of intermediate and advanced HCC.

METHODS

Patients diagnosed with intermediate-advanced HCC and initially treated with BeSiIT or LeSiIT in the Tianjin Medical University Cancer Institute and Hospital between February 2020 and July 2021 were included. The primary endpoint was progression-free survival (PFS), and the secondary endpoints were overall survival (OS), objective response rate (ORR), disease control rate (DCR), conversion rate, and treatment-related adverse events.

RESULTS

Total 127 patients met the inclusion criteria and were divided into BeSiIT and LeSiIT groups. Twenty-eight and fifty patients in the BeSiIT and LeSiIT groups, respectively, were assessed after 1:2 propensity score matching. PFS and OS rates were not significantly different between the two groups. No significant variations were noted in ORRs or DCRs according to the Response Evaluation Criteria in Solid Tumors (RECIST), and modified RECIST. BeSiIT group showed a better conversion rate than the LeSiIT group ( = 0.043). Both groups showed manageable toxicity profiles. Multivariate analysis showed that the independent factors associated with PFS were alpha-fetoprotein levels and carcinoembryonic antigen score.

CONCLUSION

In intermediate-to-advanced HCC, the BeSiIT and LeSiIT groups exhibited acceptable toxicities and comparable PFS, OS, and ORR.

摘要

背景

贝伐珠单抗联合信迪利单抗介入治疗(BeSiIT)和仑伐替尼联合信迪利单抗介入治疗(LeSiIT)是临床实践中治疗中晚期肝细胞癌(HCC)的两种常用治疗方案。

目的

比较 BeSiIT 和 LeSiIT 治疗中晚期 HCC 的临床疗效和安全性。

方法

纳入 2020 年 2 月至 2021 年 7 月在天津医科大学肿瘤医院接受 BeSiIT 或 LeSiIT 初始治疗的中晚期 HCC 患者。主要终点为无进展生存期(PFS),次要终点为总生存期(OS)、客观缓解率(ORR)、疾病控制率(DCR)、转化率和治疗相关不良事件。

结果

共纳入 127 例符合条件的患者,分为 BeSiIT 组和 LeSiIT 组。经 1:2 倾向评分匹配后,分别对 BeSiIT 组和 LeSiIT 组的 28 例和 50 例患者进行评估。两组患者的 PFS 和 OS 率无显著差异。根据实体瘤疗效评价标准(RECIST)和改良 RECIST,两组的 ORR 和 DCR 无显著差异。BeSiIT 组的转化率优于 LeSiIT 组(=0.043)。两组均具有可管理的毒性特征。多因素分析显示,与 PFS 相关的独立因素为甲胎蛋白水平和癌胚抗原评分。

结论

在中晚期 HCC 中,BeSiIT 和 LeSiIT 组的毒性可接受,PFS、OS 和 ORR 相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d298/11572639/f31d4d9e0691/WJG-30-4620-g001.jpg

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