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接受仑伐替尼和卡瑞利珠单抗治疗的HBV相关晚期肝细胞癌患者的乙肝病毒再激活

Hepatitis B Virus Reactivation in Patients With HBV-Related Advanced Hepatocellular Carcinoma Undergoing Lenvatinib and Camrelizumab Treatment.

作者信息

Sheng Bi, Wang Dong, Wang Jingjing

机构信息

Department of Pharmacy, Wuhan Third Hospital, Wuhan, China.

Department of Oncology, Wuhan Union Hospital, Wuhan, China.

出版信息

Cancer Control. 2025 Jan-Dec;32:10732748241309046. doi: 10.1177/10732748241309046.

DOI:10.1177/10732748241309046
PMID:39754312
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11700405/
Abstract

OBJECTIVE

This study aimed to evaluate hepatitis B virus (HBV) reactivation and its effect on tumor response and survival outcomes in patients with HBV-related advanced hepatocellular carcinoma (HCC) undergoing lenvatinib plus camrelizumab treatment.

METHODS

216 patients with HBV-related advanced HCC receiving lenvatinib and camrelizumab were enrolled. Overall survival (OS), progression-free survival, and tumor response were evaluated. Univariate and multivariate analyses were performed to determine risk factors for HBV reactivation.

RESULTS

HBV reactivation occurred in 24 patients (11.1%). It was associated with poor survival and tumor response in these patients. Undetectable DNA levels, the absence of antiviral therapy, and high ALT levels were identified as vital risk factors for HBV reactivation. After receiving or adjusting the antiviral strategy, tumor response improved in patients with HBV reactivation.

CONCLUSIONS

HBV reactivation could occur in patients with HBV-related HCC, treated with lenvatinib and camrelizumab, worsening tumor response and patient survival. Regular monitoring of the indicators of HBV infection and effective antiviral treatments are recommended for these patients to prevent severe complications.

摘要

目的

本研究旨在评估接受乐伐替尼联合卡瑞利珠单抗治疗的乙型肝炎病毒（HBV）相关晚期肝细胞癌（HCC）患者的HBV再激活情况及其对肿瘤反应和生存结局的影响。

方法

纳入216例接受乐伐替尼和卡瑞利珠单抗治疗的HBV相关晚期HCC患者。评估总生存期（OS）、无进展生存期和肿瘤反应。进行单因素和多因素分析以确定HBV再激活的危险因素。

结果

24例患者（11.1%）发生HBV再激活。这与这些患者的不良生存和肿瘤反应相关。未检测到DNA水平、未进行抗病毒治疗以及高ALT水平被确定为HBV再激活的重要危险因素。在接受或调整抗病毒策略后，HBV再激活患者的肿瘤反应有所改善。

结论

接受乐伐替尼和卡瑞利珠单抗治疗的HBV相关HCC患者可能发生HBV再激活，从而恶化肿瘤反应和患者生存。建议对这些患者定期监测HBV感染指标并进行有效的抗病毒治疗，以预防严重并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9373/11700405/0827d8e3d01a/10.1177_10732748241309046-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9373/11700405/0e5a9a4ce130/10.1177_10732748241309046-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9373/11700405/b574e399af89/10.1177_10732748241309046-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9373/11700405/703376bc77de/10.1177_10732748241309046-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9373/11700405/0827d8e3d01a/10.1177_10732748241309046-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9373/11700405/0e5a9a4ce130/10.1177_10732748241309046-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9373/11700405/b574e399af89/10.1177_10732748241309046-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9373/11700405/703376bc77de/10.1177_10732748241309046-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9373/11700405/0827d8e3d01a/10.1177_10732748241309046-fig4.jpg

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