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载药微球联合索拉非尼和恩沃利单抗介入栓塞治疗中晚期肾细胞癌的有效性和安全性研究

A study on the effectiveness and safety of interventional embolization using drug-loaded microspheres in combination with sorafenib and envafolimab for intermediate and advanced renal cell carcinoma.

作者信息

Chen Cheng, Shen Yanfeng, Ma Yanhong, Zhang Yingying, Zhang Shuyan, Su Na, Guo Hefei, Guo Yapeng, Zhang Xuehui, Liu Xianming, Zhang Suhua, Li Shuai, You Xin, Zhang Zhiwei, Duan Xiaoting, Li Guiying

机构信息

Department of Oncology, Affiliated Hospital of Hebei Engineering University, Handan, Hebei, China.

Cath Lab, Affiliated Hospital of Hebei Engineering University, Handan, Hebei, China.

出版信息

Front Oncol. 2025 May 29;15:1558410. doi: 10.3389/fonc.2025.1558410. eCollection 2025.

Abstract

OBJECTIVE

To investigate the effectiveness and safety of drug-loaded microsphere interventional embolization (D-TAE) in conjunction with sorafenib and envafolimab in the management of intermediate and advanced renal carcinoma.

METHODS

120 cases of intermediate and advanced renal cell carcinoma cured in the Oncology Department of our hospital from January 2022 to December 2023 were selected. Individuals in the combination group received D-TAE paired with sorafenib and envafolimab. Individuals in the D-TAE group received only D-TAE. The clinical data, clinical efficacy, vascular endothelial growth factor (VEGF), carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), mortality, progression-free survival time (PFS), objective tumor response rate (ORR) and tumor control rate (DCR) and adverse reactions were compared in both groups.

RESULTS

The proportion of individuals with ORR and DCR in the combination group was greatly increased compared to that in the D-TAE group (0.05). After 1 week and 1 month of treatment, the serum VEGF levels in both groups showed a great decrease compared to pre-treatment levels (<0.05), with the combination group demonstrating notably lower serum VEGF levels than the D-TAE group (<0.05). Following treatment, serum CA125 and CEA levels in both groups experienced a great decrease compared to pre-treatment levels, with the combination group showing notably lower levels than the D-TAE group (<0.05). Additionally, the mortality rate in the combination group was greatly lower than that in the D-TAE group, and the PFS was greatly increased in the combination group compared to the D-TAE group (<0.05). In addition, the observed adverse reactions included gastrointestinal reactions, liver and kidney damage, myelosuppression and rash. Overall, the incidence of adverse reactions in the combination group was greatly decreased than that in the D-TAE group (<0.05).

CONCLUSION

Drug-loaded microsphere interventional embolization combined with sorafenib and envafolimab has certain efficacy and acceptable safety in treating intermediate and late-stage renal tumor, providing a new treatment option for patients with renal cell carcinoma.

摘要

目的

探讨载药微球介入栓塞术(D-TAE)联合索拉非尼和恩沃利单抗治疗中晚期肾癌的有效性和安全性。

方法

选取2022年1月至2023年12月在我院肿瘤科治愈的120例中晚期肾细胞癌患者。联合组患者接受D-TAE联合索拉非尼和恩沃利单抗治疗。D-TAE组患者仅接受D-TAE治疗。比较两组患者的临床资料、临床疗效、血管内皮生长因子(VEGF)、癌胚抗原(CEA)、糖类抗原125(CA125)、死亡率、无进展生存期(PFS)、客观肿瘤缓解率(ORR)和疾病控制率(DCR)以及不良反应。

结果

联合组的ORR和DCR患者比例较D-TAE组大幅增加(P<0.05)。治疗1周和1个月后,两组血清VEGF水平均较治疗前大幅下降(P<0.05),联合组血清VEGF水平显著低于D-TAE组(P<0.05)。治疗后,两组血清CA125和CEA水平均较治疗前大幅下降,联合组水平显著低于D-TAE组(P<0.05)。此外,联合组死亡率远低于D-TAE组,联合组PFS较D-TAE组大幅延长(P<0.05)。另外,观察到的不良反应包括胃肠道反应、肝肾损害、骨髓抑制和皮疹。总体而言,联合组不良反应发生率较D-TAE组大幅降低(P<0.05)。

结论

载药微球介入栓塞术联合索拉非尼和恩沃利单抗治疗中晚期肾肿瘤具有一定疗效且安全性可接受,为肾细胞癌患者提供了一种新的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b67a/12158990/459708730886/fonc-15-1558410-g001.jpg

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