针对高级HCC的第一线系统性治疗的更新网络元分析:TACE的一致作用
Ye Rim Kim1, Euichang Kim1, Ha Il Kim2
1Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Liver cancer
|July 11, 2025
概括
通过动脉化学栓塞 (TACE) 与伦瓦丁尼布结合,为晚期肝细胞癌 (HCC) 提供了最好的生存结果. 免疫疗法组合也显示出希望,但TACE + lenvatinib 是一个有希望的组合.
科学领域:
- 肝病学和瘤学 肝病学和瘤学
- 临床试验和网络元分析
背景情况:
- 晚期肝细胞癌 (HCC) 需要有效的第一线治疗.
- 评估新的干预性和向性疗法至关重要.
研究的目的:
- 为了确定最优的第一线治疗先进的HCC.
- 使用网络元分析,比较干预性和向性疗法.
主要方法:
- 16个2/3期随机对照试验 (2018-2024) 的网络元分析.
- 涉及9,482名转移或无法切除的HCC患者.
- 对11种系统性药物和5种干预组合进行了评估,针对索拉芬尼布/伦瓦替尼布,重点关注整体存活率 (OS) 和无进展存活率 (PFS).
主要成果:
- 通过动脉化学栓塞 (TACE) + lenvatinib 证明了最大的 OS 改善 (HR 0.41).
- 几种免疫疗法组合 (sintilimab + IBI305,camrelizumab + rivoceranib,atezolizumab + bevacizumab) 也显示出显著的OS和PFS益处.
- TACE + lenvatinib,sintilimab + IBI305和阿特佐利祖马布 + 贝瓦西祖马布在特定患者亚组 (门口入侵,肝外转移,乙型肝炎) 中是有效的.
结论:
- 根据生存结果,TACE + lenvatinib 是高级HCC的主要一线治疗方法.
- 基于免疫治疗的组合代表了可行的替代方案.
- TACE + lenvatinib 的疗效可能会受到区域性乙型肝炎病毒患病率的影响.
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