刘东明, 穆瀚, 刘长富, 邢文阁, 宋天强, 李慧锴. 免疫及靶向药物联合肝动脉灌注化疗治疗晚期肝癌的回顾性分析[J]. 中国肿瘤临床, 2023, 50(17): 888-892. DOI: 10.12354/j.issn.1000-8179.2023.20230764
引用本文: 刘东明, 穆瀚, 刘长富, 邢文阁, 宋天强, 李慧锴. 免疫及靶向药物联合肝动脉灌注化疗治疗晚期肝癌的回顾性分析[J]. 中国肿瘤临床, 2023, 50(17): 888-892. DOI: 10.12354/j.issn.1000-8179.2023.20230764
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Dongming Liu, Han Mu, Changfu Liu, Wenge Xing, Tianqiang Song, Huikai Li. Retrospective analysis of immune checkpoint inhibitors and targeted treatment combined with hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2023, 50(17): 888-892. DOI: 10.12354/j.issn.1000-8179.2023.20230764
Citation: Dongming Liu, Han Mu, Changfu Liu, Wenge Xing, Tianqiang Song, Huikai Li. Retrospective analysis of immune checkpoint inhibitors and targeted treatment combined with hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2023, 50(17): 888-892. DOI: 10.12354/j.issn.1000-8179.2023.20230764
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免疫及靶向药物联合肝动脉灌注化疗治疗晚期肝癌的回顾性分析

Retrospective analysis of immune checkpoint inhibitors and targeted treatment combined with hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma

    摘要
  • 摘要:
      目的  探讨免疫及靶向药物联合肝动脉灌注化疗术（hepatic arterial infusion chemotherapy，HAIC）治疗晚期肝细胞癌（hepatocellular carcinoma，HCC）的疗效与安全性。
      方法  回顾性分析2021年4月至2022年4月天津医科大学肿瘤医院收治的34例行HAIC联合信迪利单抗及贝伐珠单抗生物类似物治疗的晚期HCC患者，以首次治疗为起点，以患者死亡、疾病进展及不可耐受的不良反应为终点，按照实体肿瘤的疗效评价（mRECIST）1.1标准进行疗效评估，随访截至2023年4月。主要研究终点为客观缓解率（objective response rate，ORR），次要研究终点为疾病控制率（disease control rate，DCR）、总生存期（overall survival， OS）、无复发生存期（disease-free survival，DFS）、手术转化率及安全性。
      结果  ORR为52.9%，DCR可达到85.3%，手术转化利率为41.1%。部分缓解（partial response，PR）组1年OS及DFS分别为94.4%、50.0%；病变稳定（stable disease，SD）+病变进展（progressive disease，PD）组患者1年OS及DFS分别为66.7%、25.0%，两组差距均有统计学意义（P=0.002及P=0.013）。常见的不良反应有恶心呕吐（38.2%）、高血压（32.4%）及血小板减少（29.4%）等，无治疗相关死亡事件发生。
      结论  HAIC联合信迪利单抗及贝伐珠单抗生物类似物治疗晚期HCC的客观缓解率高，安全性良好，为后续临床试验的开展奠定了基础。

     

    Abstract:
      Objective  To investigate the safety and efficacy of immunologic and targeted drugs combined with hepatic arterial infusion chemotherapy (HAIC) for the treatment of advanced hepatocellular carcinoma (HCC).
      Methods  A total of 34 patients with advanced HCC were retrospectively analyzed; they were admitted to the Tianjin Medical University Cancer Institute & Hospital between April 2021 and April 2022 for routine HAIC combined with sindilizumab and bevacizumab biosimilars. The treatment efficacy was assessed according to the mRECIST 1.1 criteria, with the first treatment as the starting point and patient death, disease progression, and intolerable adverse reactions as the endpoints. The patients were followed-up until April 2023. The primary endpoint was the objective response rate (ORR); the secondary endpoints were disease control rate (DCR), overall survival (OS), disease-free survival (DFS), surgical conversion rate, and safety.
      Results  The ORR was 52.9%, DCR was 85.3%, and surgical conversion rate was 41.1%. Significant differences were observed between patients in the partial response (PR) and stable disease (SD)+progressive disease (PD) groups, in terms of their 1-year OS (94.4% and 50.0%, respectively; P=0.002) and DFS (66.7% and 25.0%, respectively; P=0.013). Common adverse reactions included nausea and vomiting (38.2%), hypertension (32.4%), and thrombocytopenia (29.4%). No treatment-related deaths occurred.
      Conclusions  HAIC combined with sindilizumab and bevacizumab biosimilars for the treatment of advanced HCC showed a high objective remission rate and a favorable safety profile, demonstrating its suitability for subsequent prospective clinical trials.

     

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