免疫疗法改善了TACE或TACE加MTT在HCC患者的疗效:一个元分析
Yusheng Guo1, Zhenliang Pan2, Xuefeng Kan1
1Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Provincial Clinical Research Center for Precision Radiology & Interventional Medicine, Wuhan 430022, China; Hubei Key Laboratory of Molecular Imaging, Wuhan 430022, China.
International immunopharmacology
|January 10, 2025
概括
将免疫检查点抑制剂 (ICI) 添加到跨动脉化学栓塞 (TACE) 中,可显著改善肝细胞癌患者的生存率和反应率. 这种组合疗法可以提高疗效,而不会增加不良事件.
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:
- 跨动脉化学栓塞 (TACE) 是肝细胞癌 (HCC) 的标准治疗方法.
- 免疫检查点抑制剂 (ICI) 与TACE的整合是一个快速发展的领域.
- 需要进行全面的元分析,以整合TACE与ICI结合的现有证据.
研究的目的:
- 与TACE单独或与分子向疗法 (MTT) 相比,系统地评估TACE与ICI的疗效和安全性.
- 评估ICI对整体生存 (OS),无进展生存 (PFS),客观反应率 (ORR) 和疾病控制率 (DCR) 的影响.
- 为了确定是否添加ICI到TACE加氨酸激酶抑制剂 (TKI) 会增加不良事件.
主要方法:
- 在PubMed,Embase,Web of Science和Cochrane图书馆进行了系统的文献搜索,直到2023年7月.
- 分析包括比较TACE (±MTTs) 与TACE (±MTTs) +ICI在HC患者中的研究.
- 分析的关键结果是OS,PFS,ORR,DCR和不良事件 (AE).
主要成果:
- 分析包括20项研究,涉及2587名HCC患者.
- 与TACE单独相比,TACE + ICI显著改善了OS (HR,0.37) 和PFS (HR,0.50).与TACE单独相比,TACE + ICI显著改善了OS (HR,0.37) 和PFS (HR,0.50).
- 联合治疗也导致更高的ORR (OR,2.39) 和DCR (OR,2.30),而不会增加AE.
结论:
- 免疫检查点抑制剂增强TACE的疗效,延长HCC患者的存活时间.
- 将ICI添加到TACE + TKIs中不会导致额外的不良事件.
- 与ICI结合的TACE代表了对HCC的有前途的治疗策略.
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