TACE与regorafenib结合或不结合抗PD-1治疗,用于针对性治疗失败后晚期HCC:一个多中心的现实研究
Yan Li1, Hang Yuan1, Quan-Jun Yao1
1Department of Interventional Radiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China.
Frontiers in oncology
|November 3, 2025
概括
结合跨动脉化学栓塞 (TACE),雷戈拉费尼布和PD-1抑制剂的三重疗法显著改善了晚期肝细胞癌 (HCC) 患者在向治疗后的治疗结果. 早些时候启动雷戈拉费尼布进一步提高了无进展的生存率,并具有可管理的副作用.
科学领域:
- 肝胆道癌症 肝胆道癌症
- 医学瘤学 医学瘤学
- 免疫治疗是一种免疫疗法.
背景情况:
- 针对性治疗后的晚期肝细胞癌 (HCC) 的选择有限.
- 雷戈拉费尼布是标准的二线治疗,但其组合疗法需要现实世界的验证.
- 优化治疗时间和剂量对于组合疗法至关重要.
研究的目的:
- 为了评估结合跨动脉化学血栓化 (TACE) 与先进的HCC中regorafenib和PD-1抑制剂的疗效和安全性.
- 为了比较这种三重疗法 (TRP) 与双重疗法 (TACE + regorafenib).
- 为了评估regorafenib启动时间和剂量的对结果的影响.
主要方法:
- 188名HCC患者 (BCLC B/C) 的回顾性多中心研究,针对性治疗后失败.
- 倾向性得分匹配 (PSM) 创建了可比的组:64名患者接受三重治疗 (TRP) 和64名患者接受双重治疗 (TR).
- 主要终点:无进展生存 (PFS) 和整体生存 (OS);次要:客观反应率 (ORR),疾病控制率 (DCR),与治疗相关的不良事件 (TRAEs).
主要成果:
- 三重治疗 (TRP) 在PSM后显著改善中位数PFS (6.5vs4.6个月) 和OS (15.8vs12.1个月).
- 与双重治疗相比,TRP实现了更高的ORR (32.8%对17.2%) 和DCR (71.9%对51.6%).
- 第二线regorafenib启动显著改善了两只手臂的PFS;剂量没有显著影响生存率. 发疹在TRP组中更频繁.
结论:
- 结合TACE,雷戈拉费尼布和PD-1抑制剂优于TACE-雷戈拉费尼布双疗法,用于针对性治疗失败后的晚期HCC.
- 早些时候开始治疗雷戈拉费尼布 (二线) 与改善的PFS有关.
- 这种三重组合提供了可接受的安全性,并提高了临床疗效.
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