Addition of Immune Checkpoint Inhibitor Showed Better Efficacy for Infiltrative Hepatocellular Carcinoma Receiving Hepatic Arterial Infusion Chemotherapy and Lenvatinib: A Multicenter Retrospective Study.

IF 6.2 Q1 IMMUNOLOGY

ImmunoTargets and Therapy Pub Date : 2024-08-19 eCollection Date: 2024-01-01 DOI:10.2147/ITT.S470797

Wei Wang, Ruixia Li, Hui Li, Murong Wang, Juncheng Wang, Xiaohui Wang, Qunfang Zhou

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引用次数: 0

Abstract

Purpose: The prognosis of infiltrative hepatocellular carcinoma (HCC) is dismal. Hepatic arterial infusion chemotherapy (HAIC) plus Lenvatinib (Len) and immune checkpoint inhibitor (ICI) have shown promising results for HCC. However, this three combination therapy on infiltrative HCC is unknown. In this study, we compared HAIC plus lenvatinib (Len) and programmed cell death protein-1 (PD-1) inhibitor with HAIC plus Len for infiltrative HCC.

Patients and methods: This multi-center cohort study included patients with infiltrative HCC who received HAIC combined with Len (HAIC+Len group, n = 173) or HAIC combined with Len and PD-1 inhibitor (HAIC+Len+ICI group, n = 128) as the first-line treatment from January 2019 to December 2021. To balance any intergroup differences, one-to-one propensity score matching (PSM) was applied. Overall survival (OS) and progression-free survival (PFS) were compared between the two groups.

Results: After PSM, the median OS was 14.1 ± 1.0 and 16.1 ± 1.4 months in the HAIC+Len and HAIC+Len+ICI groups, respectively. The median PFS was 4.6 ± 0.4 months in the HAIC+Len group and 7.5 ± 0.8 months in the HAIC+Len+ICI group. The HAIC+Len+ICI group showed significantly better OS (hazard ratio [HR], 0.66; 95% CI, 0.49-0.90; P = 0.008) and PFS (HR, 0.53; 95% confident index [CI], 0.40-0.70; P < 0.001) compared with the HAIC+Len group. Subgroup analysis revealed that for OS in HCC without metastasis, the addition of PD-1 inhibitor was not significant (HR, 0.68; 95% CI, 0.43-1.07; P = 0.091). No difference was observed in OS between low (2-3 cycles) and high (4-6 cycles) level of HAIC cycles (HR, 0.99; 95% CI, 0.67-1.44; P = 0.938).

Conclusion: The HAIC+Len+ICI group had a longer PFS and OS compared with the HAIC+Len group, demonstrating an acceptable safety profile. This triple combination strategy may be an alternative treatment for infiltrative HCC management.

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对于接受肝动脉灌注化疗和仑伐替尼治疗的浸润性肝细胞癌，添加免疫检查点抑制剂显示出更好的疗效：一项多中心回顾性研究

目的：浸润性肝细胞癌（HCC）的预后不容乐观。肝动脉灌注化疗（HAIC）加上伦伐替尼（Len）和免疫检查点抑制剂（ICI）对 HCC 有着良好的疗效。然而，这三种联合疗法对浸润性 HCC 的治疗效果尚不清楚。在这项研究中，我们比较了HAIC加仑伐替尼（Len）和程序性细胞死亡蛋白-1（PD-1）抑制剂与HAIC加仑伐替尼治疗浸润性HCC的效果：这项多中心队列研究纳入了2019年1月至2021年12月期间接受HAIC联合Len（HAIC+Len组，n = 173）或HAIC联合Len和PD-1抑制剂（HAIC+Len+ICI组，n = 128）一线治疗的浸润性HCC患者。为平衡组间差异，采用了一对一倾向评分匹配（PSM）。比较了两组患者的总生存期（OS）和无进展生存期（PFS）：PSM后，HAIC+Len组和HAIC+Len+ICI组的中位OS分别为14.1±1.0个月和16.1±1.4个月。HAIC+Len组的中位PFS为（4.6±0.4）个月，HAIC+Len+ICI组为（7.5±0.8）个月。与HAIC+Len组相比，HAIC+Len+ICI组的OS（危险比[HR]，0.66；95% CI，0.49-0.90；P = 0.008）和PFS（HR，0.53；95% 置信指数[CI]，0.40-0.70；P < 0.001）明显更好。亚组分析显示，对于无转移的HCC患者，加用PD-1抑制剂对其OS无显著影响（HR，0.68；95% CI，0.43-1.07；P = 0.091）。低水平（2-3个周期）和高水平（4-6个周期）的HAIC周期之间的OS无差异（HR，0.99；95% CI，0.67-1.44；P = 0.938）：结论：与HAIC+Len组相比，HAIC+Len+ICI组的PFS和OS更长，安全性也可接受。这种三联疗法可能是治疗浸润性 HCC 的一种替代疗法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ImmunoTargets and Therapy IMMUNOLOGY-

CiteScore

16.50

自引率

0.00%

发文量

审稿时长

16 weeks

期刊介绍： Immuno Targets and Therapy is an international, peer-reviewed open access journal focusing on the immunological basis of diseases, potential targets for immune based therapy and treatment protocols employed to improve patient management. Basic immunology and physiology of the immune system in health, and disease will be also covered.In addition, the journal will focus on the impact of management programs and new therapeutic agents and protocols on patient perspectives such as quality of life, adherence and satisfaction.