Shen Yanjun, Xu Yawen, Teng Ying, Ding Xiaoyan, Chen Jinglong
Department of Oncology, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
Front Pharmacol. 2025 May 13;16:1533471. doi: 10.3389/fphar.2025.1533471. eCollection 2025.
OBJECTIVE: This study attempted to comprehensively assess the clinical outcomes of cases with progressive HCC (pHCC) undergoing treatment with TKI and ICI in conjunction with TACE, as compared to the combination of TKI with TACE alone. METHODS: From March 2019 to January 2022, this cohort comprised 82 cases who received TACE in conjunction with TKI and 52 cases who were treated with TACE plus TKI alone. The propensity scores was used to mitigate selection bias. RESULTS: The multivariate analysis further reinforced that liver cirrhosis (HR = 1.233, 95% CI: 1.024-1.484, P = 0.027), tumor diameter (HR = 1.283, 95% CI: 1.086-1.515, P = 0.003), and the treatment strategy (HR = 0.495, 95% CI: 0.264-0.793, P = 0.000) were independently linked to OS, underscoring their prognostic relevance. CONCLUSION: Incorporating TACE, TKI, and ICI remarkably enhanced both PFS and OS relative to TACE with TKI alone, positioning it as a more efficacious first-line therapeutic strategy for unresectable HCC, while maintaining an acceptable safety profile in clinical settings.
目的：本研究试图全面评估接受酪氨酸激酶抑制剂（TKI）和免疫检查点抑制剂（ICI）联合经动脉化疗栓塞术（TACE）治疗的进展期肝细胞癌（pHCC）病例的临床结局，并与单纯TKI联合TACE治疗进行比较。 方法：2019年3月至2022年1月，该队列包括82例接受TACE联合TKI治疗的病例和52例仅接受TACE加TKI治疗的病例。采用倾向评分法减轻选择偏倚。 结果：多因素分析进一步证实，肝硬化（HR = 1.233，95%CI：1.024 - 1.484，P = 0.027）、肿瘤直径（HR = 1.283，95%CI：1.086 - 1.515，P = 0.003）和治疗策略（HR = 0.495，95%CI：0.264 - 0.793，P = 0.000）与总生存期（OS）独立相关，突出了它们的预后相关性。 结论：与单纯TKI联合TACE相比，联合使用TACE、TKI和ICI显著提高了无进展生存期（PFS）和OS，使其成为不可切除HCC更有效的一线治疗策略，同时在临床环境中保持了可接受的安全性。
Cardiovasc Intervent Radiol. 2024-6
Liver Cancer. 2023-4-5
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