PD(L)1 Inhibitors Plus Lenvatinib Vs Atezolizumab Plus Bevacizumab Combined With HAIC for Unresectable HCC: A Propensity Score Matching Study.

IF 6.2 Q1 IMMUNOLOGY

ImmunoTargets and Therapy Pub Date : 2025-01-25 eCollection Date: 2025-01-01 DOI:10.2147/ITT.S502350

Zhaoqian He, Hua Chen, Chen Liang, Xiang Tang, Lingmin Jiang, Feihu Xie, Qi Liu, Yun Zheng

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引用次数: 0

Abstract

Purpose: To compare the clinical outcomes of different systemic therapies, specifically PD(L)1 inhibitors plus Lenvatinib versus Atezolizumab plus Bevacizumab, when combined with hepatic arterial infusion chemotherapy (HAIC) based on the FOLFOX regimen (oxaliplatin, fluorouracil, and leucovorin) as first line treatment for unresectable hepatocellular carcinoma.

Patients and methods: This real-world retrospective study enrolled 294 patients with unresectable HCC. All patients received HAIC in combination with either PD(L)1 inhibitors plus Lenvatinib (PLEN-HAIC) or Atezolizumab plus Bevacizumab (AT-HAIC). Propensity score matching (PSM) was performed to balance patient characteristics. The overall response rate (ORR), progression-free survival (PFS), and overall survival (OS) were compared.

Results: After PSM, 80 and 130 patients received AT-HAIC and PLEN-HAIC, respectively. No significant differences were found in ORR between the AT-HAIC and PLEN-HAIC groups (50.0% vs 40.0% per RECIST, p = 0.202; 60.0% vs 57.7% per mRECIST, p = 0.853). Both groups showed similar disease control rates. Median PFS was 14.3 months for PLEN-HAIC versus 8.8 months for AT-HAIC (p = 0.018). Median OS was significantly better in the PLEN-HAIC group (p = 0.045, both not reached). Subgroup analysis revealed that Lenvatinib showed a better OS compared to Bevacizumab when combined with HAIC and PDL1 inhibitors (p = 0.023).

Conclusion: PLEN-HAIC offers significant survival benefits over AT-HAIC in advanced HCC. Given its remarkable efficacy, PLEN-HAIC could be a promising first-line option for unresectable HCC.

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PD(L)1抑制剂+ Lenvatinib Vs Atezolizumab + Bevacizumab联合HAIC治疗不可切除的HCC：一项倾向评分匹配研究

目的：比较不同全身疗法的临床结果，特别是PD(L)1抑制剂+ Lenvatinib与Atezolizumab + Bevacizumab，在FOLFOX方案（奥沙利铂、氟尿嘧啶和亚叶酸钙）的基础上联合肝动脉输注化疗（HAIC）作为一线治疗不可切除的肝细胞癌。患者和方法：这项现实世界的回顾性研究纳入了294例不可切除的HCC患者。所有患者均接受HAIC联合PD(L)1抑制剂+ Lenvatinib （PLEN-HAIC）或Atezolizumab +贝伐单抗（AT-HAIC）。采用倾向评分匹配（PSM）来平衡患者特征。比较总有效率（ORR）、无进展生存期（PFS）和总生存期（OS）。结果：经PSM治疗后，分别有80例和130例患者接受了AT-HAIC和PLEN-HAIC治疗。AT-HAIC组和PLEN-HAIC组的ORR无显著差异(50.0% vs 40.0% / RECIST, p = 0.202；60.0% vs 57.7%, p = 0.853)。两组的疾病控制率相似。PLEN-HAIC的中位PFS为14.3个月，而AT-HAIC为8.8个月（p = 0.018）。PLEN-HAIC组的中位OS明显更好（p = 0.045，均未达到）。亚组分析显示，Lenvatinib与HAIC和PDL1抑制剂联合使用时，OS优于贝伐单抗（p = 0.023）。结论：在晚期HCC中，PLEN-HAIC比AT-HAIC具有显著的生存优势。鉴于其显著的疗效，PLEN-HAIC可能是治疗不可切除HCC的一线选择。

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.