肝动脉输液化疗与系统疗法相结合,顺序或同时用于晚期肝细胞癌
Yu-Zhe Cao1,2,3, Jia-Yu Pan1,2,3, Guang-Lei Zheng1,2,3
1Department of Minimally Invasive Interventional Radiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, People's Republic of China.
同时的三重疗法,包括肝动脉输液化疗 (HAIC),向疗法和PD-(L) 1阻塞,可显著改善巴塞罗那诊所肝癌 (BCLC) 阶段C肝细胞癌 (HCC) 患者的生存率,而不是连续的管理.
科学领域:
- 肝胆道癌症 肝胆道癌症
- 在瘤学瘤学.
- 药理疗法 药理疗法 药理疗法
背景情况:
- 肝细胞癌 (HCC) 是一个主要的全球健康问题.
- 巴塞罗那诊所肝癌 (BCLC) C期HCC呈现出晚期疾病,治疗选择有限.
- 肝动脉输液化疗 (HAIC) 结合向治疗和PD-(L) 1阻塞提供了一种新的治疗策略.
研究的目的:
- 为了比较同时 (SI) 与HAIC,向治疗和PD-L) 1阻断的顺序 (SE) 管理的有效性和安全性.
- 为了评估BCLC阶段C的患者的治疗结果,HCC.
主要方法:
- 从2018年1月到2022年6月,回顾性招募575名BCLCC阶段C HCC患者.
- 倾向性得分匹配 (PSM) 以创建可比的SE和SI组 (每组182名患者).
- 卡普兰-梅尔分析和日志等级测试的总生存期 (OS) 和无进展生存期 (PFS);瘤反应和不良事件 (AE) 的评估.
主要成果:
- 与序列治疗相比,同时进行的三重治疗显示中位数的生存时间 (28.8 vs. 16.1个月; P=.002) 和PFS (9.6 vs. 7.0个月; P=.01) 显著更长.
- 在SI组中,客观反应率更高 (58%对37%;P<.001).
- 在SE组的60.9%和SI组的70.3%发生了3-4级AEs,没有报告5级AEs.
结论:
- 同时的HAIC加上向治疗和PD-(L) 1阻断显著改善了BCLCCC阶段的结果.
- 在没有意外不良事件的情况下,SI疗法提供了比SE疗法更好的预后.
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