Lee Ji Yeon, Lee Jaejun, Kim Suho, Yoo Jae-Sung, Kim Ji Hoon, Yang Keungmo, Han Ji Won, Jang Jeong Won, Choi Jong Yong, Yoon Seung Kew, Chun Ho Jong, Oh Jung Suk, Sung Pil Soo
Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Division of Hepatology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Front Oncol. 2024 Dec 12;14:1495321. doi: 10.3389/fonc.2024.1495321. eCollection 2024.
There is no established second-line treatment for hepatocellular carcinoma (HCC) following atezolizumab-bevacizumab (ate-beva) failure. This study assessed the efficacy of hepatic arterial infusion chemotherapy (HAIC) as a salvage therapy by comparing survival outcomes and treatment responses between HAIC as a first-line treatment and as a second-line option after ate-beva failure.
We retrospectively analyzed 100 patients with advanced HCC treated with HAIC between March 2022 and July 2024. Patients were categorized into two groups: those who received HAIC as initial therapy (first-line HAIC group) and those who received HAIC following ate-beva failure (post-ate-beva group). Survival outcomes were assessed with Kaplan-Meier curves and log-rank tests, and factors associated with survival were identified through Cox regression analysis.
The post-ate-beva group exhibited longer overall survival (OS) (median OS 12.4 months) compared to the first-line HAIC group (median OS 6.8 months) (p = 0.073). Progression-free survival (PFS) was significantly superior in the post-ate-beva group (median PFS 8.2 months) compared to the first-line HAIC group (median PFS 3.1 months) (p = 0.018). The objective response rate was also notably higher in the post-ate-beva group than in the first-line HAIC group (35.3% vs. 18.1%, p = 0.031). In multivariate analysis, HAIC following ate-beva failure, compared to first-line HAIC, was significantly associated with favorable outcomes for both OS (p = 0.014) and PFS (p = 0.006).
The superior survival outcomes and treatment responses observed in the post-ate-beva group suggest that HAIC may be an effective second-line treatment option for advanced HCC following ate-beva therapy failure. However, due to the retrospective nature and small sample size of the study, further prospective studies with larger patient populations are needed to strengthen the evidence.
对于阿替利珠单抗-贝伐珠单抗（阿替-贝伐）治疗失败后的肝细胞癌（HCC），尚无既定的二线治疗方案。本研究通过比较肝动脉灌注化疗（HAIC）作为一线治疗和阿替-贝伐失败后的二线选择的生存结局和治疗反应，评估了HAIC作为挽救治疗的疗效。
我们回顾性分析了2022年3月至2024年7月期间接受HAIC治疗的100例晚期HCC患者。患者分为两组：接受HAIC作为初始治疗的患者（一线HAIC组）和阿替-贝伐失败后接受HAIC治疗的患者（阿替-贝伐后组）。采用Kaplan-Meier曲线和对数秩检验评估生存结局，并通过Cox回归分析确定与生存相关的因素。
与一线HAIC组（中位总生存期[OS] 6.8个月）相比，阿替-贝伐后组的总生存期更长（中位OS 12.4个月）（p = 0.073）。与一线HAIC组（中位无进展生存期[PFS] 3.1个月）相比，阿替-贝伐后组的无进展生存期显著更长（中位PFS 8.2个月）（p = 0.018）。阿替-贝伐后组的客观缓解率也显著高于一线HAIC组（35.3%对18.1%，p = 0.031）。在多变量分析中，与一线HAIC相比，阿替-贝伐失败后进行HAIC与OS（p = 0.014）和PFS（p = 0.006）的良好结局显著相关。
阿替-贝伐后组观察到的优越生存结局和治疗反应表明，HAIC可能是阿替-贝伐治疗失败后晚期HCC的一种有效二线治疗选择。然而，由于本研究的回顾性性质和小样本量，需要进一步开展更大患者群体的前瞻性研究以加强证据。
