The Efficacy and Safety of Bevacizumab Plus Anti-PD-1/PD-L1 Inhibitors in Combination with Hepatic Arterial Infusion Chemotherapy for Initially Unresectable Hepatocellular Carcinoma.

IF 6.2 Q1 IMMUNOLOGY
ImmunoTargets and Therapy Pub Date : 2024-10-26 eCollection Date: 2024-01-01 DOI:10.2147/ITT.S478685
Xiang Tang, Jinbin Chen, Wei Peng, Zhoutian Yang, Li Hu, Zhiwei Ye, Yizhen Fu, Dandan Hu, Zhongguo Zhou, Minshan Chen, Yaojun Zhang, Jun-Cheng Wang
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引用次数: 0

Abstract

Objection: To report the efficacy and safety of triple combination therapy with bevacizumab plus anti-PD-1 (BP1) or anti-PD-L1 inhibitors (BPL) combined with hepatic arterial infusion chemotherapy (HAIC) as a first-line treatment for initially unresectable hepatocellular carcinoma (uHCC).

Methods: In this retrospective study, patients with initially uHCC received either BP1-HAIC or BPL-HAIC as first-line treatment. The primary endpoint was progression-free survival (PFS); secondary endpoints included overall survival (OS), objective response rate (ORR) and disease control rate (DCR).

Results: Between January 2020 and December 2022, a total of 136 patients with initially uHCC received triple combination therapy, with 76 in the BP1-HAIC group and 60 in the BPL-HAIC group. The median PFS for the entire cohort was 11.1 months (95% CI, 8.0-13.7 months), and the median OS was 22.4 months (95% CI, 21.3- not reached). Comparative analysis revealed no significant differences in PFS (HR, 0.91, P = 0.69) or OS (HR, 0.71, P = 0.31) between the BP1-HAIC and BPL-HAIC groups. The ORR was 46.3% per RECIST v1.1 and 66.9% per mRECIST, with a DCR of 83.1% under both criteria. Common adverse events (AEs) included hypoalbuminemia and elevated aspartate/alanine aminotransferase, with 5.1% (7/136) experienced upper gastrointestinal bleeding. Multivariate Cox analysis identified tumor number and BCLC stage as independent prognostic factors for OS, and tumor number for PFS.

Conclusion: Triple combination therapy demonstrated significant therapeutic efficacy and tumor response in initially uHCC. No notable differences in outcomes were observed between the BP1-HAIC and BPL-HAIC groups. AEs were manageable in clinical practice.

贝伐单抗加抗PD-1/PD-L1抑制剂联合肝动脉灌注化疗治疗最初无法切除的肝细胞癌的有效性和安全性。
目的报告贝伐单抗加抗PD-1(BP1)或抗PD-L1抑制剂(BPL)三联疗法联合肝动脉灌注化疗(HAIC)作为初期不可切除肝细胞癌(uHCC)一线治疗的有效性和安全性:在这项回顾性研究中,最初患有uHCC的患者接受了BP1-HAIC或BPL-HAIC作为一线治疗。主要终点是无进展生存期(PFS);次要终点包括总生存期(OS)、客观反应率(ORR)和疾病控制率(DCR):2020年1月至2022年12月期间,共有136名初诊uHCC患者接受了三联疗法,其中BP1-HAIC组76人,BPL-HAIC组60人。整个队列的中位 PFS 为 11.1 个月(95% CI,8.0-13.7 个月),中位 OS 为 22.4 个月(95% CI,21.3- 未达到)。比较分析显示,BP1-HAIC 组和 BPL-HAIC 组的 PFS(HR,0.91,P = 0.69)或 OS(HR,0.71,P = 0.31)无明显差异。根据RECIST v1.1标准,ORR为46.3%,根据mRECIST标准,ORR为66.9%,两种标准的DCR均为83.1%。常见不良事件(AEs)包括低白蛋白血症和天门冬氨酸/丙氨酸氨基转移酶升高,5.1%(7/136)的患者出现上消化道出血。多变量考克斯分析发现,肿瘤数目和BCLC分期是OS的独立预后因素,肿瘤数目是PFS的独立预后因素:结论:三联疗法对初治 uHCC 有显著疗效和肿瘤反应。BP1-HAIC组和BPL-HAIC组的疗效无明显差异。在临床实践中,AEs 是可控的。
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来源期刊
CiteScore
16.50
自引率
0.00%
发文量
7
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.
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