Núñez Kelley G, Sandow Tyler, Grahovac Alexandre, Vallejo-Calzada Ricardo, Gimenez Juan, Bohorquez Humberto, Cohen Ari, Mizrahi Jonathan, Du Lingling, Thevenot Paul
Institute of Translational Research, Ochsner Health System, New Orleans, LA 70121, USA.
Interventional Radiology, Ochsner Health System, New Orleans, LA 70121, USA.
Cancers (Basel). 2025 Aug 23;17(17):2745. doi: 10.3390/cancers17172745.
Immune checkpoint inhibitors (ICIs) have emerged as first-line therapy for advanced-stage HCC with modest response rates (<33%). Combination treatments offer the potential to improve response rates while improving outcomes. This study evaluates the safety and outcomes of first-line Yttrium-90 plus ICI (Y-ICI). A retrospective, multi-center study was conducted in HCC patients receiving first-line Y-ICI with atezolizumab plus bevacizumab (Atezo/Bev) or tremelimumab plus durvalumab (Treme/Durva). Treatment response was evaluated at follow-up for planned Y treatment cycle. Time-to-event measures of time to progression (TTP), progression-free survival (PFS), and overall survival (OS) served as primary endpoints, with first cycle response rates and AEs as secondary outcomes. This study included 37 patients receiving Y-ICI from 2021 to 2024 (16-month median follow-up). The cohort was predominantly Child-Pugh A (92%) with HCV-related cirrhosis (67%), advanced stage (54%), and a median index HCC size of 8.0 cm (IQR: 6-12 cm). Grade 3-4 AEs occurred in six patients (16%). The target objective response (OR) rate was 83%, with a 50% target complete response (CR) rate. Overall OR was 61% with an overall CR of 39%. Median PFS was 11 months with 1-year rates of 50%. Patients with a target CR had improved TTP ( = 0.004), PFS ( = 0.003), and OS ( = 0.003). The cohort's 2-year OS was 41% with a median OS of 19 months (CI: 12-37 months). First-line Y-ICI therapy in HCC is safe and effective, with no deviation in anticipated results. Patients achieving target CR showed significantly improved TTP, PFS, and OS, supporting target CR as an optimal treatment target.
免疫检查点抑制剂（ICIs）已成为晚期肝癌的一线治疗方法，但其缓解率适中（<33%）。联合治疗有可能提高缓解率并改善治疗结果。本研究评估了一线钇-90联合ICI（Y-ICI）的安全性和治疗结果。对接受一线Y-ICI联合阿替利珠单抗加贝伐单抗（阿替利珠单抗/贝伐单抗）或曲美木单抗加度伐利尤单抗（曲美木单抗/度伐利尤单抗）治疗的肝癌患者进行了一项回顾性多中心研究。在计划的Y治疗周期随访时评估治疗反应。至疾病进展时间（TTP）、无进展生存期（PFS）和总生存期（OS）等事件发生时间指标作为主要终点，首个周期缓解率和不良事件作为次要结果。本研究纳入了2021年至2024年接受Y-ICI治疗的37例患者（中位随访16个月）。该队列主要为Child-Pugh A级（92%），伴有丙型肝炎病毒相关肝硬化（67%）、晚期（54%），中位索引肝癌大小为8.0 cm（四分位间距：6-12 cm）。6例患者（16%）发生3-4级不良事件。目标客观缓解（OR）率为83%，目标完全缓解（CR）率为50%。总体OR为61%，总体CR为39%。中位PFS为11个月，1年率为50%。达到目标CR的患者TTP（P = 0.004）、PFS（P = 0.003）和OS（P = 0.003）均有所改善。该队列的2年OS为41%，中位OS为19个月（可信区间：12-37个月）。肝癌一线Y-ICI治疗安全有效，预期结果无偏差。达到目标CR的患者TTP、PFS和OS显著改善，支持目标CR作为最佳治疗目标。
