Patients with uHCC and Child-Pugh B8/9 also benefit from a combination of antiangiogenic agents and PD-1 inhibitors: a multicenter real-world study.

IF 2.7 3区医学 Q3 ONCOLOGY

Acta Oncologica Pub Date : 2025-05-05 DOI:10.2340/1651-226X.2025.42652

Xiaoyan Ding, Xue Yin, Linlin Zheng, Lin Zhou, Junke Hu, Wei Sun, Lei Sun, Yanjun Shen, Ying Teng, Yawen Xu, Wendong Li, Mei Liu, Jinglong Chen

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引用次数: 0

Abstract

Background and purpose: Patients with unresectable hepatocellular carcinoma (uHCC) and Child-Pugh grade B face limited treatment options and poor outcomes. This study aims to evaluate whether the effect and safety of combining tyrosine kinase inhibitors (TKIs) with progressive disease (PD)-1 inhibitors in uHCC patients with Child-Pugh B7 (CP7) and B8/9 (CP8/9) differ.

Methods: This multicenter retrospective study included 179 uHCC patients with Child-Pugh B (CP7 group: n = 106; CP8/9 group: n = 73), receiving a combination of lenvatinib/sorafenib/other TKIs and PD-1 inhibitors between December 2020 and March 2023. Progression-free survival (PFS) and overall survival (OS) were defined as the primary endpoint. Secondary endpoints included the objective response rate (ORR) and safety.

Results: The median PFS and OS for the entire cohort were 7.3 months (95% confidence intervals [CI]: 6.3-8.3) and 16.0 months (95% CI: 12.9-19.1), respectively. No statistically significant differences were observed between CP7 and CP8/9 groups in PFS (7.8 vs. 6.3 months, p = 0.28), OS (17.8 vs. 14.0 months, p = 0.20), ORR (33.0% vs. 27.4%, p = 0.42), or safety profiles. However, the CP8/9 group had significantly higher rates of TKI dose reductions (46.6% vs. 31.1%, p = 0.04) and discontinuations (57.5% vs. 24.5%, p < 0.001). Notably, 30.2% of patients maintained sustained radiographic responses despite advanced liver dysfunction.

Interpretation: Combining TKIs with PD-1 inhibitors is an effective and well-tolerated option for HCC patients with Child-Pugh B, including those with CP8/9.

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uHCC和Child-Pugh B8/9患者也受益于抗血管生成药物和PD-1抑制剂的联合治疗：一项多中心现实世界研究。

背景和目的：不可切除的肝细胞癌（uHCC）和Child-Pugh B级患者面临有限的治疗选择和不良的预后。本研究旨在评估酪氨酸激酶抑制剂（TKIs）联合进展性疾病(PD)-1抑制剂在Child-Pugh B7 （CP7）和B8/9 （CP8/9）的uHCC患者中的疗效和安全性是否存在差异。方法：本多中心回顾性研究纳入179例合并Child-Pugh B的uHCC患者(CP7组：n = 106；CP8/9组：n = 73)，在2020年12月至2023年3月期间接受lenvatinib/sorafenib/其他TKIs和PD-1抑制剂的联合治疗。无进展生存期（PFS）和总生存期（OS）被定义为主要终点。次要终点包括客观缓解率（ORR）和安全性。结果：整个队列的中位PFS和OS分别为7.3个月（95%可信区间[CI]: 6.3-8.3）和16.0个月（95% CI: 12.9-19.1）。CP7组和CP8/9组在PFS（7.8个月vs 6.3个月，p = 0.28）、OS（17.8个月vs 14.0个月，p = 0.20）、ORR （33.0% vs 27.4%, p = 0.42）或安全性方面均无统计学差异。然而，CP8/9组TKI剂量减少率（46.6%比31.1%,p = 0.04）和停药率（57.5%比24.5%,p < 0.001）显著高于CP8/9组。值得注意的是，30.2%的患者在晚期肝功能不全的情况下仍能保持持续的影像学反应。结论：TKIs联合PD-1抑制剂对于Child-Pugh B HCC患者（包括CP8/9患者）是一种有效且耐受性良好的选择。

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

Acta Oncologica 医学-肿瘤学

CiteScore

4.30

自引率

3.20%

发文量

301

审稿时长

3 months

期刊介绍： Acta Oncologica is a journal for the clinical oncologist and accepts articles within all fields of clinical cancer research. Articles on tumour pathology, experimental oncology, radiobiology, cancer epidemiology and medical radio physics are also welcome, especially if they have a clinical aim or interest. Scientific articles on cancer nursing and psychological or social aspects of cancer are also welcomed. Extensive material may be published as Supplements, for which special conditions apply.