Efficacy and Safety of Durvalumab Plus Tremelimumab in Hepatocellular Carcinoma Patients With Portal Vein Thrombosis and High Tumor Burden: A Multicenter Retrospective Analysis.

IF 3.4 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Hepatology Research Pub Date : 2025-09-06 DOI:10.1111/hepr.70033

Takeshi Hatanaka, Yutaka Yata, Atsushi Hiraoka, Toshifumi Tada, Masashi Hirooka, Kazuya Kariyama, Joji Tani, Masanori Atsukawa, Koichi Takaguchi, Ei Itobayashi, Satoru Kakizaki, Shinya Fukunishi, Kunihiko Tsuji, Toru Ishikawa, Kazuto Tajiri, Hidenori Toyoda, Yuichi Koshiyama, Chikara Ogawa, Hiroki Nishikawa, Takashi Nishimura, Kazuhito Kawata, Hisashi Kosaka, Kosuke Matsui, Atsushi Naganuma, Hironori Tanaka, Hideko Ohama, Hidekatsu Kuroda, Tomomitsu Matono, Tomoko Aoki, Hironori Ochi, Michitaka Imai, Shinichiro Nakamura, Shohei Komatsu, Hideyuki Tamai, Jumpei Okamura, Yuki Kanayama, Kazunari Tanaka, Fujimasa Tada, Osamu Yoshida, Kazuhiro Nouso, Asahiro Morishita, Akemi Tsutsui, Takuya Nagano, Norio Itokawa, Tomomi Okubo, Taeang Arai, Takanori Matsuura, Hidenao Noritake, Hirayuki Enomoto, Masaki Kaibori, Takumi Fukumoto, Yoichi Hiasa, Masatoshi Kudo, Takashi Kumada

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引用次数: 0

Abstract

Aims: This study aimed to evaluate the therapeutic efficacy of durvalumab and tremelimumab (Dur/Tre) in patients with hepatocellular carcinoma (HCC) who had a tumor thrombus in the main portal vein trunk (Vp4) or high tumor burden (HTB).

Methods: A total of 309 patients with BCLC stage B or C HCC who received Dur/Tre between March 2023 and October 2024 were included. HTB was defined as the presence of at least one of the following radiological findings: ≥ 50% liver involvement by HCC, bile duct invasion, or the presence of Vp4.

Results: Both the patients with Vp4 and HTB-positive group had significantly higher proportions of BCLC stage C disease (p = 0.01 and 0.007, respectively) and serum DCP levels ≥ 100 mAU/mL (p = 0.03 and < 0.001, respectively), and significantly higher neutrophil-to-lymphocyte ratio (p = 0.04 and p = 0.004, respectively) compared to their respective counterparts. While the objective response rate did not significantly differ between the HTB-positive and HTB-negative groups (21.6% vs. 16.2%, p = 0.5), it was significantly higher in patients with Vp4 than in those without (42.9% vs. 15.6%, p = 0.02). There were no significant differences in progression-free survival or overall survival (OS) between patients with and without Vp4 (p = 0.1 and 0.3, respectively) and nor between the HTB-positive and HTB-negative groups (both p = 0.3). Among patients with both Vp4 and HTB, responders had longer OS than non-responders.

Conclusions: Dur/Tre may be a viable treatment option for patients with Vp4 and HTB.

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Durvalumab联合Tremelimumab治疗门静脉血栓形成和高肿瘤负荷肝细胞癌患者的疗效和安全性：一项多中心回顾性分析

目的：本研究旨在评价durvalumab和tremelimumab （Dur/Tre）在门静脉主干（Vp4）有肿瘤血栓或高肿瘤负荷（HTB）的肝细胞癌（HCC）患者中的治疗效果。方法：共纳入309例在2023年3月至2024年10月期间接受Dur/Tre治疗的BCLC B期或C期HCC患者。HTB被定义为至少存在以下影像学表现之一：HCC累及肝脏≥50%，胆管侵犯或Vp4的存在。结果：Vp4和HTB阳性组患者BCLC C期病变比例（p = 0.01和0.007）和血清DCP水平≥100 mAU/mL （p = 0.03）均显著高于对照组。结论：Dur/Tre可能是Vp4和HTB患者可行的治疗方案。

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

Hepatology Research 医学-胃肠肝病学

CiteScore

8.30

自引率

14.30%

发文量

124

审稿时长

1 months

期刊介绍： Hepatology Research (formerly International Hepatology Communications) is the official journal of the Japan Society of Hepatology, and publishes original articles, reviews and short comunications dealing with hepatology. Reviews or mini-reviews are especially welcomed from those areas within hepatology undergoing rapid changes. Short communications should contain concise definitive information.