Efficiency and Safety of HAIC Combined with Lenvatinib and PD-1 Inhibitor for Advanced Hepatocellular Carcinoma with Lung Metastasis: A Multicenter Propensity Score Matching Analysis.

IF 4.4 Q1 IMMUNOLOGY
ImmunoTargets and Therapy Pub Date : 2025-09-02 eCollection Date: 2025-01-01 DOI:10.2147/ITT.S542811
Song Chen, Ning Wang, Yi Xiao, Xiongying Jiang, Feng Shi, Hongjie Cai, Shuangyan Tang, Wenbo Guo, Wenquan Zhuang
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引用次数: 0

Abstract

Purpose: This study aimed to evaluate the clinical efficiency and safety of hepatic arterial infusion chemotherapy (HAIC) combined with lenvatinib and programmed cell death protein-1 (PD-1) inhibitor for patients with hepatocellular carcinoma (HCC) and lung metastasis.

Methods: In this multicenter retrospective study, treatment-naive patients with advanced (BCLC stage C) HCC and lung metastases who received lenvatinib and PD-1 inhibitor - with or without HAIC - between January 2019 and January 2024 were reviewed. Propensity score matching (PSM) was applied to balance baseline characteristics between the two groups. The primary endpoint was overall survival (OS). Secondary endpoints included progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR) according to RECIST 1.1 criteria, as well as adverse events (AEs).

Results: A total of 422 eligible patients were included, with 169 receiving HAIC (HLP group) and 253 receiving lenvatinib plus PD-1 inhibitor (LP group). After 1:1 PSM, 151 patients were matched in each group. The HLP group demonstrated significantly longer median OS compared to the LP group (26.0 versus 8.4 months; hazard ratio [HR]: 0.36; 95% confidence interval [CI]: 0.27-0.49; P < 0.001). Median PFS was also improved in the HLP group (7.6 versus 5.5 months; HR: 0.77; 95% CI: 0.59-1.00; P = 0.048). ORR and DCR were significantly higher in the HLP group (ORR: 47.7% versus 20.5%, P < 0.001; DCR: 86.1% versus 72.2%, P = 0.003). Although the HLP group experienced a higher incidence of both all-grade and grade 3/4 AEs, all were manageable, and no grade 5 events occurred.

Conclusion: HAIC combined with lenvatinib and PD-1 inhibitor shows promise as a treatment for advanced HCC with lung metastases, offering improved prognosis and a manageable safety profile.

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HAIC联合Lenvatinib和PD-1抑制剂治疗晚期肝细胞癌伴肺转移的有效性和安全性:多中心倾向评分匹配分析
目的:本研究旨在评价肝动脉灌注化疗(HAIC)联合lenvatinib和程序性细胞死亡蛋白-1 (PD-1)抑制剂治疗肝细胞癌(HCC)合并肺转移患者的临床疗效和安全性。方法:在这项多中心回顾性研究中,回顾了2019年1月至2024年1月期间接受lenvatinib和PD-1抑制剂治疗的晚期(BCLC C期)HCC和肺转移患者(伴或不伴HAIC)。使用倾向评分匹配(PSM)来平衡两组之间的基线特征。主要终点是总生存期(OS)。次要终点包括根据RECIST 1.1标准的无进展生存期(PFS)、客观缓解率(ORR)和疾病控制率(DCR),以及不良事件(ae)。结果:共纳入422例符合条件的患者,其中169例接受HAIC治疗(HLP组),253例接受lenvatinib + PD-1抑制剂治疗(LP组)。1:1 PSM后,每组匹配151例患者。与LP组相比,HLP组的中位生存期明显更长(26.0个月vs 8.4个月;风险比[HR]: 0.36; 95%可信区间[CI]: 0.27-0.49; P < 0.001)。HLP组的中位PFS也得到改善(7.6个月vs 5.5个月;HR: 0.77; 95% CI: 0.59-1.00; P = 0.048)。HLP组的ORR和DCR显著高于HLP组(ORR: 47.7%比20.5%,P < 0.001; DCR: 86.1%比72.2%,P = 0.003)。尽管HLP组所有级别和3/4级ae的发生率都较高,但所有ae都是可控的,没有发生5级事件。结论:HAIC联合lenvatinib和PD-1抑制剂有望治疗晚期肝细胞癌伴肺转移,预后改善,安全性可控。
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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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