瑞戈非尼联合疗法治疗晚期肝细胞癌：联合或不联合经动脉化疗栓塞术

Regorafenib Combination Therapy in Advanced Hepatocellular Carcinoma: With or without Transarterial Chemoembolization.

作者信息

Cao Lei, Lu Xiangyu, Chen Haoqing, Yu Xiang, Li Jinze, Peng Yi, Gu Lu, Feng Ji, Xie Ping, Liu Yaben

机构信息

Department of Radiology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China,

Department of hepatobiliary surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.

出版信息

Oncology. 2024 Nov 27:1-14. doi: 10.1159/000542775.

DOI:10.1159/000542775

PMID:39602912

Abstract

INTRODUCTION

The effectiveness and tolerability of triple therapy, which combines regorafenib, a programmed death 1 (PD-1) inhibitor, and transarterial chemoembolization (TACE), were compared to dual therapy consisting of regorafenib and a PD-1 inhibitor in patients with advanced hepatocellular carcinoma (HCC).

METHODS

A retrospective analysis was conducted on patients with advanced HCC who underwent second-line therapy from March 2019 to June 2022 at multiple centers. Patients were stratified into two groups: dual therapy (comprising regorafenib and a PD-1 inhibitor) and triple therapy (consisting of regorafenib, a PD-1 inhibitor, and TACE). Propensity score matching (PSM) was used to control for potential confounding variables.

RESULTS

After PSM, 112 eligible patients were included, with 56 in the triple therapy group and 56 in the dual therapy group. Median overall survival (OS) was significantly longer in the triple therapy group (15.4 vs. 8.9 months, p < 0.001), as was median progression-free survival (6.8 vs. 3.3 months, p < 0.001). The objective response rate (37.5% vs. 5.4%, p < 0.001) and disease control rate (73.2% vs. 44.6%, p = 0.002) were significantly higher in the triple therapy group compared to the dual therapy group. The incidence and severity of adverse events were similar between the two groups.

CONCLUSION

Triple therapy demonstrated superior survival benefits compared to dual therapy in patients with advanced HCC. Additionally, the safety profiles of the two treatment regimens were comparable.

摘要

引言

在晚期肝细胞癌（HCC）患者中，将瑞戈非尼、程序性死亡1（PD-1）抑制剂与经动脉化疗栓塞术（TACE）联合的三联疗法的有效性和耐受性，与由瑞戈非尼和PD-1抑制剂组成的双联疗法进行了比较。

方法

对2019年3月至2022年6月在多个中心接受二线治疗的晚期HCC患者进行回顾性分析。患者被分为两组：双联疗法（由瑞戈非尼和PD-1抑制剂组成）和三联疗法（由瑞戈非尼、PD-1抑制剂和TACE组成）。采用倾向评分匹配（PSM）来控制潜在的混杂变量。

结果

经过PSM后，纳入了112例符合条件的患者，三联疗法组56例，双联疗法组56例。三联疗法组的中位总生存期（OS）显著更长（15.4个月对8.9个月，p<0.001）），中位无进展生存期也是如此（6.8个月对3.3个月，p<0.001）。与双联疗法组相比，三联疗法组的客观缓解率（37.5%对5.4%，p<0.001）和疾病控制率（73.2%对44.6%，p=0.002）显著更高。两组不良事件的发生率和严重程度相似。