针对不可切除的HCC进行跨动脉化疗的免疫向治疗:系统性审查和元分析
Huipeng Fang1,2, Qiao Ke3, Shiji Wu4
1Department of Radiation Oncology, Jiangxi Clinical Research Center for Cancer, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China.
Frontiers in immunology
|August 19, 2024
概括
将跨动脉化疗与免疫治疗结合起来,可以改善不可切除的肝细胞癌 (uHCC) 的结果. 这种方法提高了反应率和生存率,但可能会增加肝酶水平.
科学领域:
- 肝胆瘤学 肝胆瘤学
- 干预性放射学 干预性放射学
- 免疫治疗是一种免疫疗法.
背景情况:
- 不切除的肝细胞癌 (uHCC) 带来了治疗挑战.
- 超动脉化学栓塞 (TACE) 是对HHCC的标准治疗方法.
- 新兴的免疫疗法需要评估TACE的组合策略.
研究的目的:
- 系统地审查TACE的临床疗效和安全性,结合对HHCC的免疫向治疗.
- 为了比较组合治疗与单独免疫治疗在HHCC患者的结果.
主要方法:
- 在2024年5月31日之前对PubMed,Embase和Cochrane图书馆数据库进行系统审查.
- 包括比较具有或没有TACE的免疫向治疗的研究.
- 主要结局:完全响应 (CR),客观响应率 (ORR),疾病控制率 (DCR),无进展生存率 (PFS),整体生存率 (OS). 通过严重不良事件评估的安全性.
主要成果:
- 分析了16项涉及1789名患者 (TACE + 免疫疗法) 和1215名患者 (仅免疫疗法) 的研究.
- 联合治疗显著改善了CR (OR=2.12),ORR (OR=2.78),DCR (OR=2.46),PFS (HR=0.59) 和OS (HR=0.51) 的情况.
- 在联合治疗中发现ALT和AST水平增加,在各种患者亚组中观察到好处.
结论:
- 与免疫治疗相结合的TACE增强了HHCC的局部控制和长期疗效.
- 这种组合策略提供了显著的生存益处.
- 增加肝脏并发症的可能性需要仔细监测.
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