晚期肝细胞癌的第一线治疗:三臂实体世界比较
Robert Mahn1, Oscar André Glüer1, Farsaneh Sadeghlar1
1Department of Internal Medicine I, University Hospital of Bonn, Bonn, Germany.
Journal of hepatocellular carcinoma
|January 19, 2024
概括
与索拉费尼布和伦瓦提尼布相比,阿提佐利祖马布/贝瓦西祖马布 (Atez/Bev) 在晚期肝细胞癌 (HCC) 中显示出更高的生存结果. 然而,伦瓦提尼布的反应率与Atez/Bev相似,索拉芬尼布在肝功能受损的患者中有效.
科学领域:
- 肝胆瘤学 肝胆瘤学
- 医学瘤学 医学瘤学
- 临床研究是临床研究.
背景情况:
- 晚期肝细胞癌 (HCC) 有几种一线全身治疗选择.
- 关键的治疗方法包括阿特佐利祖马布/贝瓦齐祖马布 (Atez/Bev),索拉费尼布和伦瓦提尼布.
研究的目的:
- 为了比较Atez/Bev,sorafenib和lenvatinib作为先进HCC的第一线治疗方法的实际有效性.
- 分析特定患者子组的治疗结果.
主要方法:
- 对177名晚期HCC患者的回顾性分析,这些患者接受了Atez/Bev (n=38),lenvatinib (n=21) 或sorafenib (n=118) 的治疗.
- 主要终点:客观应答率 (ORR),无进展生存率 (PFS) 和15个月的整体存活率 (15个月的OS).
- 亚组分析包括肝功能,病因,先前治疗和毒性.
主要成果:
- 阿特斯/贝夫的15个月生存期 (15.03个月) 与索拉费尼布 (9.43个月,p=0.04) 和伦瓦提尼布 (8.93个月,p=0.05) 相比,显著更长.
- 阿特斯/贝夫获得了最高的ORR (31.6%) 和最长的PFS中位数 (7.97个月),明显优于索拉费尼布 (ORR4.2%,PFS4.57个月).
- 伦瓦提尼布在ORR (28.6%) 和PFS (3.77个月) 中显示与Atez/Bev相比没有劣势. 在肝功能受损的患者中,索拉芬尼不劣.
结论:
- 阿特斯/贝夫显示最长的PFS和15个月的OS,特别是在肝功能稳定或之前SIRT的患者中.
- 伦瓦提尼布在治疗反应方面与Atez/Bev不逊色.
- 索拉芬尼似乎对肝功能恶化的患者最有效.
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