经动脉化疗栓塞术（TACE）、酪氨酸激酶抑制剂（TKIs）和免疫检查点抑制剂（ICIs）用于不可切除的巴塞罗那临床肝癌（BCLC）分期B期和C期肝细胞癌的转化治疗。
Conversion therapy with TACE, TKIs, and ICIs for unresectable BCLC stage B and C hepatocellular carcinoma.
作者信息
Wang Zhuoran, Zhang Cunzhen, Yin Jianhua, Li Nan
机构信息
Department of Hepatic Surgery I (Ward I) Shanghai Eastern Hepatobiliary Surgery Hospital, Navy Medical University, Shanghai, China.
Department of Epidemiology, Faculty of Navy Medicine, Navy Medical University, Shanghai, China.
出版信息
Front Immunol. 2025 Jun 10;16:1451965. doi: 10.3389/fimmu.2025.1451965. eCollection 2025.
BACKGROUND AND AIMS
Most Hepatocellular carcinoma (HCC) diagnoses occur at advanced stages precluding radical surgical resections. Conversion therapy offers a viable chance for patients with unresectable HCC (uHCC) to become eligible for curative surgery. Despite the application of various treatment modalities for conversion therapy, uncertainties persist regarding its efficacy. Consequently, we collected clinical data to evaluate the prognosis of TACE+TKI+ICI conversion therapy and compared it with the prognoses of other conversion therapies in the literature. We aimed to elucidate the potential superiority of triplet therapy as the optimal option among the existing conversion therapy regimens, by using this comprehensive analysis.
METHODS
From January, 2019, to November, 2022, we collected data from 69 patients with HCC undergoing conversion therapy with the TACE+TKI+ICI triplet therapy. Ultimately, we analyzed data from 57 patients at BCLC Stages B and C in our study. We also conducted a comprehensive literature review on conversion therapy for uHCC by searching PubMed and Web of Science databases and gathered data from 9 studies comprising a total of 560 patients.
RESULTS
The conversion and disease control rate (DCR) in our cohort reached 14.0% (95% CI, 9.4-18.6%) and 66.7% (95% CI, 60.5-72.9%), respectively. When compared to the conversion rates in the literature, the triplet therapy demonstrated significant benefits, underscoring the potential efficacy of the TACE+TKI+ICIs triplet therapy.
CONCLUSION
Our results presented improved conversion rates in patients with uHCC following TACE+TKI+ICI triplet therapy. However, overall survival (OS) and recurrence-free survival (RFS) were similar to those of other treatment modalities in the literature.
CLINICAL TRIAL REGISTRATION
ClinicalTrials.gov, identifier ChiCTR2400084896.
背景与目的
大多数肝细胞癌（HCC）在诊断时已处于晚期，无法进行根治性手术切除。转化治疗为不可切除的HCC（uHCC）患者提供了获得根治性手术的可行机会。尽管应用了多种治疗方式进行转化治疗，但其疗效仍存在不确定性。因此，我们收集了临床数据以评估经动脉化疗栓塞（TACE）+酪氨酸激酶抑制剂（TKI）+免疫检查点抑制剂（ICI）转化治疗的预后，并与文献中其他转化治疗的预后进行比较。我们旨在通过这项综合分析阐明三联疗法作为现有转化治疗方案中最佳选择的潜在优势。
方法
2019年1月至2022年11月，我们收集了69例接受TACE+TKI+ICI三联疗法进行转化治疗的HCC患者的数据。最终，我们分析了研究中57例BCLC B期和C期患者的数据。我们还通过检索PubMed和Web of Science数据库，对uHCC的转化治疗进行了全面的文献综述，并收集了9项研究的数据，共560例患者。
结果
我们队列中的转化和疾病控制率（DCR）分别达到14.0%（95%置信区间，9.4 - 18.6%）和66.7%（95%置信区间，60.5 - 72.9%）。与文献中的转化率相比，三联疗法显示出显著优势，突出了TACE+TKI+ICI三联疗法的潜在疗效。
结论
我们的结果表明，TACE+TKI+ICI三联疗法后uHCC患者的转化率有所提高。然而，总生存期（OS）和无复发生存期（RFS）与文献中其他治疗方式相似。
临床试验注册
ClinicalTrials.gov，标识符ChiCTR2400084896。
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