免疫治疗对晚年老年患者不可切除的肝细胞癌的影响:现实世界的临床研究
Shun Kaneko1, Yasuhiro Asahina1, Miyako Murakawa1
1Department of Gastroenterology and Hepatology, Institute of Science Tokyo, Tokyo, Japan.
Cancer medicine
|August 26, 2025
概括
免疫疗法对老年肝细胞癌 (HCC) 患者有效,特别是那些肝功能良好的人. 然而,在免疫检查点抑制剂 (ICI) 后的进一步治疗对年轻患者比非常老年患者更有好处.
科学领域:
- 肝细胞癌 (HCC) 研究
- 老年瘤学
- 免疫治疗的有效性
背景情况:
- 患有肝细胞癌 (HCC) 的老年人群的增加.
- 需要澄清老年HCC患者的免疫治疗结果和指标.
研究的目的:
- 评估老年HCC患者免疫治疗的实际结果.
- 在这个人群中确定免疫治疗的预后因素和施用指标.
主要方法:
- 在接受一线免疫治疗的286名不可切除的HCC患者中进行了回顾性多中心研究.
- 分类为晚年老年人 (≥75岁) 和非晚年老年人 (≤74岁).
- 总生存时间 (OS),无进展生存时间 (PFS) 和预后因素的分析.
主要成果:
- 晚年老年人 (LE) 组表现较差,肝功能标志物较低,但疾病控制率 (82. 0%) 和安全性概况相似.
- 在LE组的中位数是分别为25. 6个月和10. 5个月.
- 在非LE患者中,免疫检查点抑制剂 (ICI) 治疗显著改善了生存状况,而不是LE患者.
结论:
- 免疫疗法在老年HCC患者中有效且耐受良好,肝功能保持 (mALBI级1/ 2a).
- 在ICI治疗后,非LE患者比LE患者更受益.
- 治疗策略应考虑老年HCC患者的年龄和肝功能.
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