酪氨酸激酶抑制剂在不同病因的晚期肝癌患者中耐受性良好，非病毒性病因患者的生存率较低。

Tyrosine kinase inhibitors were well-tolerated among patients with different etiologies of advanced HCC with lower survival in non-viral patients.

作者信息

Barakat Eman M F, Kohla Mohamed, Dabees Hossam, Shousha Hend Ibrahim, Moustafa Ehab F, El-Kassas Mohamed, Aziz Mona Shoukry, Elkhateeb Eman, Abdelaziz Ashraf Omar, Abdelmalek Mohamed Omar, Azmy Aly, Tawheed Ahmed, Aboganob Walaa Mosaad, Taha Hossam, Lithy Rania, Radwan Ahmed, Ghoraba Dalia, Sayed Hamdy, Nassief Anwar, Elhelbawy Mostafa, Nabeel Mohamed Mahmoud, Medhat Mohamed A, Askar Safaa Ragab, Marwan Eman, Rewisha Eman, Elbaz Tamer, Ahmed Sayed Hassan, Elfouly Nevien Fouad, Abdeen Nermeen, Abdelmaksoud Ahmed Hosni, Abdeltawab Asmaa A, Shamkh Mostafa Abd Alfattah, Ramadan Ahmed, Abdelrazek Yasser Arafat, Bassam Mohamed, Sayed Sayed Ahmed, Hussein Rasha Salah, Alrajhi Ammar, Allam Allam Elsayed, Seyam Omnia A, Said Mohamed

机构信息

Hepatoma Group, Tropical Medicine Department, Ain Shams University, Cairo, Egypt.

Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Menoufia, Egypt.

出版信息

Sci Rep. 2025 Jun 27;15(1):20323. doi: 10.1038/s41598-025-05828-x.

DOI:10.1038/s41598-025-05828-x

PMID:40579411

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12205039/

Abstract

We studied the characteristics and survival of patients with sorafenib-treated HCC and impact of underlying etiology on outcomes. This retrospective multicenter study recruited patients with sorafenib-treated advanced HCC (12/2016 to 4/2023) till death or the study end (2/2024). Time to progression (TTP) and overall survival (OS) were recorded. We evaluated; Clinico-laboratory and imaging predictors of OS, The impact of underlying etiology on tumor variables, outcomes and tolerance for sorafenib > 6 months. This study included 706 patients. Median duration of Sorafenib therapy was 240.00 (90.00-360.00) days. Median OS was 314.00(146.00-601.00) days. Median TTP was 180.00(90.00-330.00) days. COX regression revealed that the independent factors of mortality were baseline AST, Tumor size, hepatic vein thrombosis (HVT), development of jaundice and shifting to Regorafenib. Advanced HCCs were more common on top of non-cirrhotic non-viral and HBV-related liver disease. Adverse events, TTP and tumor response didn't differ with the underlying etiology. Median OS was lower in non-viral-related HCC than HCV-related HCC (218.00 versus 326.50 days, P-value = 0.048). Patients who continued sorafenib > 6 months had lower AFP, HVT, adverse effects and better tumor response after 3 months. OS is lower in non-viral Sorafenib-treated HCC compared with viral-related HCC and Sorafenib was well-tolerated among different HCC etiologies.

摘要

我们研究了接受索拉非尼治疗的肝癌患者的特征和生存情况，以及潜在病因对治疗结果的影响。这项回顾性多中心研究纳入了接受索拉非尼治疗的晚期肝癌患者（2016年12月至2023年4月），直至死亡或研究结束（2024年2月）。记录疾病进展时间（TTP）和总生存期（OS）。我们评估了：OS的临床实验室和影像学预测因素；潜在病因对肿瘤变量、治疗结果以及索拉非尼治疗超过6个月耐受性的影响。本研究共纳入706例患者。索拉非尼治疗的中位持续时间为240.00（90.00 - 360.00）天。中位OS为314.00（146.00 - 601.00）天。中位TTP为180.00（90.00 - 330.00）天。COX回归分析显示，死亡的独立危险因素为基线谷草转氨酶、肿瘤大小、肝静脉血栓形成（HVT）、黄疸的出现以及改用瑞戈非尼。晚期肝癌在非肝硬化非病毒性和HBV相关肝病基础上更为常见。不良事件、TTP和肿瘤反应在不同潜在病因之间无差异。非病毒相关肝癌的中位OS低于HCV相关肝癌（218.00天对326.50天，P值 = 0.048）。持续使用索拉非尼超过6个月的患者，其甲胎蛋白水平较低、HVT发生率较低、不良反应较少，且3个月后肿瘤反应较好。与病毒相关肝癌相比，非病毒相关的接受索拉非尼治疗的肝癌患者OS较低，且索拉非尼在不同病因的肝癌患者中耐受性良好。