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TACE联合抗血管生成疗法加PD-1抑制剂与抗血管生成疗法加PD-1抑制剂治疗晚期肝癌的ALBI分级分析

ALBI Grade Analyses of TACE Combined with Anti-Angiogenesis Therapies Plus PD-1 Inhibitors versus Anti-Angiogenesis Therapies Plus PD-1 Inhibitors in Advanced HCC.

作者信息

Hong Xin, Hu Di, Zhou Wen-Jie, Wang Xiu-De, Huang Li-Hua, Huang Tian-An, Guan Yi-Wei, Qian Jingyu, Ding Wen-Bin

机构信息

Department of Interventional Radiology, Affiliated Hospital 2 of Nantong University, Nantong, People's Republic of China.

Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.

出版信息

J Hepatocell Carcinoma. 2024 Dec 19;11:2505-2514. doi: 10.2147/JHC.S485867. eCollection 2024.

Abstract

OBJECTIVE

To evaluate the baseline albumin-bilirubin (ALBI) grade's role in advanced hepatocellular carcinoma (HCC) receiving transarterial chemoembolization (TACE) plus anti-angiogenesis therapies and PD-1 inhibitors (TACE+TP) versus anti-angiogenesis therapies and PD-1 inhibitors (TP).

METHODS

This multicenter retrospective study enrolled advanced HCC undergoing TACE+TP or TP from January 2019 to June 2023 at three hospitals in China. The primary outcomes were time to progression of the ALBI grade and change in ALBI score between the initial baseline and the final assessment point available, the secondary outcomes consisted of overall survival (OS) as well as progression-free survival (PFS).

RESULTS

One hundred and eighty-three patients were ultimately enrolled in this study for analysis, of whom 44 were categorized as having an ALBI grade 1 (TACE+TP, n = 23; TP, n = 21) and 139 were classified as ALBI grade 2 (n = 77; n = 62). Time to progression of the ALBI grade, indicating liver function deterioration, was comparable between the TACE+TP and TP groups (median, 11.2 vs 19.3 months; P = 0.353). Change in ALBI score between the initial baseline and the final assessment point available was comparable among the two groups (difference in least squares mean, 0.084). Irrespective of the initial ALBI grade, patients in TACE+TP group exhibited a significant enhancement in OS and displayed a promising trend towards better PFS.

CONCLUSION

TACE+TP had no negative influence on liver function and enhanced survival regardless of baseline ALBI grade when compared to TP in advanced HCC patients.

摘要

目的

评估基线白蛋白-胆红素(ALBI)分级在接受经动脉化疗栓塞(TACE)联合抗血管生成疗法及程序性死亡受体1(PD-1)抑制剂(TACE+TP)治疗的晚期肝细胞癌(HCC)患者与接受抗血管生成疗法及PD-1抑制剂(TP)治疗的患者中的作用。

方法

本多中心回顾性研究纳入了2019年1月至2023年6月在中国三家医院接受TACE+TP或TP治疗的晚期HCC患者。主要结局指标为ALBI分级进展时间以及初始基线与最终可获得评估点之间ALBI评分的变化,次要结局指标包括总生存期(OS)和无进展生存期(PFS)。

结果

本研究最终纳入183例患者进行分析,其中44例被归类为ALBI 1级(TACE+TP组,n = 23;TP组,n = 21),139例被归类为ALBI 2级(n = 77;n = 62)。TACE+TP组和TP组中提示肝功能恶化的ALBI分级进展时间相当(中位数分别为11.2个月和19.3个月;P = 0.353)。两组间初始基线与最终可获得评估点之间ALBI评分的变化相当(最小二乘均值差异为0.084)。无论初始ALBI分级如何,TACE+TP组患者的OS均显著提高,且PFS有改善的趋势。

结论

在晚期HCC患者中,与TP相比,TACE+TP对肝功能无负面影响,且无论基线ALBI分级如何均能提高生存率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00d0/11668322/c984bf45127c/JHC-11-2505-g0001.jpg

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