Transarterial Chemoembolization, Molecular Targeted Treatments, and Programmed Death-(Ligand)1 Inhibitors, for Hepatocellular Carcinoma with Lung Metastasis: A Retrospective Cohort Study.

IF 4.2 3区 医学 Q2 ONCOLOGY
Journal of Hepatocellular Carcinoma Pub Date : 2025-05-23 eCollection Date: 2025-01-01 DOI:10.2147/JHC.S509120
Junjie Lu, Xiang Chen, Yongfa Liu, Yi Ding, Bo Li, Jin Yang, Wei Peng, Xiaoli Yang
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Abstract

Background: Treatment options for patients with hepatocellular carcinoma (HCC) and lung metastases are diverse, requiring a personalized approach. Current CNLC guidelines recommend systemic therapy and focal radiation, emphasizing the roles of molecular targeted treatments (MTT) and programmed death-(ligand)1 (PD-[L]1) inhibitors. However, the efficacy of combining TACE with these treatments remains uncertain.

Purpose: To compare the efficacy and adverse reactions of TACE combined with MTT and PD-(L)1 versus MTT and (PD-[L]1) in patients with HCC and lung metastasis.

Materials and methods: We retrospectively analyzed data from patients treated between January 2019 and May 2024 at the Affiliated Hospital of Southwest Medical University and West China Hospital of Sichuan University. Stabilized inverse probability weighting was employed to reduce bias. The primary outcome was overall survival (OS); secondary outcomes included progression-free survival (PFS) and objective response rate (ORR).

Results: Among 167 patients, 141 received TACE, MTT, and PD-(L)1, while 26 received MTT and PD-(L)1. The median follow-up times were 28 and 29 months, respectively. After weighting, baseline characteristics were well balanced. The median OS was significantly longer in the TACE group (15 months) compared to the MTT group (8 months; p=0.023), and PFS was also longer (8 months vs 5 months; p=0.038). For liver lesions, ORR was 42.6% in the TACE group and 46.2% in the MTT group (p=0.73); for lung lesions, ORR was 26.2% and 19.2%, respectively (p=0.449). Safety profiles were similar, except for a higher incidence of rash in the MTT group.

Conclusion: TACE combined with MTT and PD-(L)1 demonstrated better outcomes for patients with liver cancer and lung metastases compared to MTT and PD-(L)1 alone, without increasing complication rates, suggesting a promising first-line treatment option.

经动脉化疗栓塞、分子靶向治疗和程序性死亡(配体)1抑制剂治疗肝细胞癌伴肺转移:一项回顾性队列研究
背景:肝细胞癌(HCC)和肺转移患者的治疗选择是多种多样的,需要个性化的方法。目前CNLC指南推荐全身治疗和局灶放疗,强调分子靶向治疗(MTT)和程序性死亡-(配体)1 (PD-[L]1)抑制剂的作用。然而,TACE联合这些治疗的疗效仍不确定。目的:比较TACE联合MTT和PD-(L)1与MTT和(PD-[L]1)治疗肝癌合并肺转移患者的疗效和不良反应。材料和方法:回顾性分析2019年1月至2024年5月在西南医科大学附属医院和四川大学华西医院治疗的患者资料。采用稳定逆概率加权来减小偏差。主要终点是总生存期(OS);次要结局包括无进展生存期(PFS)和客观缓解率(ORR)。结果:167例患者中,TACE + MTT + PD-(L)1治疗141例,MTT + PD-(L)1治疗26例。中位随访时间分别为28个月和29个月。加权后,基线特征得到很好的平衡。TACE组的中位生存期(15个月)明显长于MTT组(8个月;p=0.023), PFS也更长(8个月vs 5个月;p = 0.038)。对于肝脏病变,TACE组的ORR为42.6%,MTT组为46.2% (p=0.73);肺部病变的ORR分别为26.2%和19.2% (p=0.449)。除了MTT组皮疹发生率较高外,安全性概况相似。结论:TACE联合MTT和PD-(L)1治疗肝癌和肺转移患者的预后优于单独MTT和PD-(L)1,且未增加并发症发生率,是一种有希望的一线治疗方案。
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
CiteScore
0.50
自引率
2.40%
发文量
108
审稿时长
16 weeks
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