阿替利珠单抗联合贝伐单抗治疗肝细胞癌后酪氨酸激酶抑制剂及度伐鲁单抗联合曲美木单抗的治疗结果

Treatment Outcomes of Tyrosine Kinase Inhibitors and Durvalumab Plus Tremelimumab After Atezolizumab Plus Bevacizumab for Hepatocellular Carcinoma.

作者信息

Ishihara Nobuaki, Komatsu Shohei, Yano Yoshihiko, Fujishima Yoshimi, Ishida Jun, Kido Masahiro, Gon Hidetoshi, Fukushima Kenji, Urade Takeshi, Yoshida Toshihiko, Tai Kentaro, Arai Keisuke, Yanagimoto Hiroaki, Toyama Hirochika, Matsuura Takanori, Tada Toshifumi, Kodama Yuzo, Fukumoto Takumi

机构信息

Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.

Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan;

出版信息

Anticancer Res. 2025 Jan;45(1):251-260. doi: 10.21873/anticanres.17412.

DOI:10.21873/anticanres.17412

PMID:39740814

Abstract

BACKGROUND/AIM: Atezolizumab plus bevacizumab (AteBev) is widely used as a first-line treatment for advanced hepatocellular carcinoma (HCC). However, evidence regarding the optimal drug sequence following AteBev treatment is limited. This study aimed to compare the treatment outcomes between tyrosine kinase inhibitors (TKIs) and durvalumab plus tremelimumab (DurTre) following AteBev treatment.

PATIENTS AND METHODS

Overall, 134 consecutive patients who received AteBev for advanced HCC were enrolled in this study. Treatment outcomes were retrospectively compared between TKIs (AteBev→TKI group) and DurTre (AteBev→DurTre group).

RESULTS

The AteBev→TKI and Ate→DurTre groups included 46 and 7 patients, respectively. The AteBev→TKI group had significantly longer median progression-free survival after second-line treatment (3.6 vs. 0.94 months, p<0.001). The disease control rate was significantly higher in the AteBev→TKI group (p=0.020). The serum alpha-fetoprotein levels significantly decreased at one month in the AteBev→TKI group (0.909 vs. 1.435, p=0.035), whereas the albumin-bilirubin score significantly decreased at one month in the AteBev→TKI group (0.875 vs. 0.952, p=0.017). Each group reported no new unmanageable adverse events.

CONCLUSION

TKIs may be a more optimal drug sequence than DurTre after AteBev treatment from an oncological perspective. TKIs following AteBev treatment require careful monitoring for deteriorating liver function.

摘要

背景/目的：阿替利珠单抗联合贝伐珠单抗（AteBev）被广泛用作晚期肝细胞癌（HCC）的一线治疗方案。然而，关于AteBev治疗后最佳用药顺序的证据有限。本研究旨在比较阿替利珠单抗联合贝伐珠单抗治疗后酪氨酸激酶抑制剂（TKIs）与度伐利尤单抗联合曲美木单抗（DurTre）的治疗效果。

患者与方法

本研究共纳入134例连续接受AteBev治疗的晚期HCC患者。对酪氨酸激酶抑制剂组（AteBev→TKI组）和度伐利尤单抗联合曲美木单抗组（AteBev→DurTre组）的治疗效果进行回顾性比较。

结果

AteBev→TKI组和Ate→DurTre组分别有46例和7例患者。AteBev→TKI组二线治疗后的中位无进展生存期显著更长（3.6个月对0.94个月，p<0.001）。AteBev→TKI组的疾病控制率显著更高（p=0.020）。AteBev→TKI组在1个月时血清甲胎蛋白水平显著下降（0.909对1.435，p=0.035），而AteBev→TKI组在1个月时白蛋白-胆红素评分显著下降（0.875对0.952，p=0.017）。每组均未报告新的难以处理的不良事件。