Xu Jing, Wang Xin, Jia Zhenya, Sun Guoping
Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China.
Medicine (Baltimore). 2025 Mar 14;104(11):e41814. doi: 10.1097/MD.0000000000041814.
The combination of immune checkpoint inhibitors targeting anti-programmed cell death-1 (anti-PD-1) or anti-programmed death ligand-1 (anti-PD-L1) with antiangiogenic agents has emerged as a revolutionary therapy for advanced hepatocellular carcinoma (aHCC). Key antiangiogenic medications encompass monoclonal antibodies targeting vascular endothelial growth factor (anti-VEGF mAbs) and multiple kinase inhibitors (MKIs). The aim of this study is to assess the difference of efficacy and safety between 2 combination therapies. This study retrospectively examined the outcomes of 57 patients with aHCC who underwent first-line treatment with a combination of immune checkpoint inhibitors and antiangiogenic therapy at the First Affiliated Hospital of Anhui Medical University, from September 2018 to July 2023. The analysis, conducted using SPSS software, focused on patient outcomes such as tumor response (assessed according to modified Response Evaluation Criteria in Solid Tumors criteria), objective response rate, disease control rate, progression-free survival, overall survival, and safety. Comparisons among different groups were also made. The anti-PD-1/anti-PD-L1-anti-VEGF mAbs group showed a trend of higher partial response rate (37.50% vs 22.45%), objective response rate (37.50% vs 24.49%), disease control rate (62.50% vs 59.18%), and seemed to achieve longer median progression-free survival (14.93 vs 14.90 months) and median overall survival (15.80 vs 11.10 months) without higher grade 3 or higher adverse events comparing to anti-PD-1/anti-PD-L1-MKIs group. Subgroup analysis showed that the anti-PD-1-lenvatinib group achieved longer median progression-free survival (23.97 months), while the anti-PD-1-regorafenib group achieved longer median overall survival (37.97 months). The anti-PD-1/anti-PD-L1 combined with anti-VEGF mAbs was effective and tolerable compared to anti-PD-1/anti-PD-L1-MKIs in aHCC. The addition of lenvatinib or regorafenib may provide promising incremental benefit for patients with aHCC.
靶向抗程序性细胞死亡蛋白1（anti-PD-1）或抗程序性死亡配体1（anti-PD-L1）的免疫检查点抑制剂与抗血管生成药物联合使用，已成为晚期肝细胞癌（aHCC）的一种革命性治疗方法。关键的抗血管生成药物包括靶向血管内皮生长因子的单克隆抗体（anti-VEGF mAbs）和多种激酶抑制剂（MKIs）。本研究的目的是评估两种联合治疗方法在疗效和安全性上的差异。本研究回顾性分析了2018年9月至2023年7月在安徽医科大学第一附属医院接受免疫检查点抑制剂和抗血管生成治疗联合一线治疗的57例aHCC患者的治疗结果。使用SPSS软件进行分析，重点关注患者的肿瘤反应（根据实体瘤改良反应评估标准进行评估）、客观缓解率、疾病控制率、无进展生存期、总生存期和安全性等结果。还对不同组进行了比较。与anti-PD-1/anti-PD-L1-MKIs组相比，anti-PD-1/anti-PD-L1-anti-VEGF mAbs组显示出更高的部分缓解率（37.50%对22.45%）、客观缓解率（37.50%对24.49%）、疾病控制率（62.50%对59.18%）的趋势，并且似乎实现了更长的中位无进展生存期（14.93对14.90个月）和中位总生存期（15.80对11.10个月），且3级及以上不良事件发生率没有更高。亚组分析显示，anti-PD-1-乐伐替尼组的中位无进展生存期更长（23.97个月），而anti-PD-1-瑞戈非尼组的中位总生存期更长（37.97个月）。在aHCC中，与anti-PD-1/anti-PD-L1-MKIs相比，anti-PD-1/anti-PD-L1联合anti-VEGF mAbs有效且耐受性良好。添加乐伐替尼或瑞戈非尼可能为aHCC患者带来有希望的额外益处。
