以免疫疗法治疗肝细胞癌的同时使用药物和临床结果:多中心分析
Jun-Zhe Yi1, Jie Xu1, Jiang-Zheng Zeng2
1Department of Minimally Invasive Interventional Therapy, Liver Cancer Study and Service Group, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China.
Frontiers in immunology
|December 15, 2025
概括
抗生素使用对接受免疫检查点抑制剂 (ICI) 的肝细胞癌 (HCC) 患者的存活率产生负面影响. 早期与治疗相关的不良事件 (TRAEs) 的葡萄糖皮质类药物可以改善结果,突出显示在HCC ICI治疗中药物管理的重要性.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 药理学 药理学是指药理学的学科.
背景情况:
- 免疫检查点抑制剂 (ICI) 在治疗肝细胞癌 (HCC) 中至关重要.
- 同时服用的药物对HCCICI疗效的影响尚不清楚.
- 了解药物影响对于优化HCC治疗结果至关重要.
研究的目的:
- 为了研究同时服用药物和ICI在HCC患者的疗效之间的关联.
- 评估特定药物类对生存,瘤反应和与治疗相关的不良事件 (TRAE) 的影响.
- 确定影响HCC.ICI治疗结果的预后因素.
主要方法:
- 一项851名接受ICI (2018-2022) 的HCC患者的多中心队列研究.
- 在ICI开始后30天内使用的药物的评估.
- 使用多变量回归模型分析整体存活率 (OS),无进展存活率 (PFS),瘤反应 (RECIST 1.1),以及TRAE.
主要成果:
- 抗生素使用与显著减少的OS和PFS有关 (P<0.01).
- 抗生素使用独立预测了更糟糕的生存结果 (OS HR 1.88,PFS HR 1.60).
- 葡萄糖皮质醇用于早期TRAEs与改善的OS相关 (HR 0.25),与预防性使用不同. 抗生素,H2RA和葡萄糖皮质类药物增加了TRAE的发生率.
结论:
- 抗生素的使用是治疗ICI的HCC患者的负面预后因素.
- 早期TRAE管理中的葡萄糖皮质类药物可能会提高生存效益.
- 同时服用的药物显著影响TRAE,需要在HCCICI治疗期间仔细考虑.
更多相关视频
相关概念视频
Tumor Immunotherapy
1.7K
Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.
1.7K
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
459
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
459
Combination Therapies and Personalized Medicine
5.8K
Combining two or more treatment methods increases the life span of cancer patients while reducing damage to vital organs or tissue from the overuse of a single treatment. Combination therapy also targets different cancer-inducing pathways, thus reducing the chances of developing resistance to treatment.
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
5.8K
Treatment Resistant Cancers
3.7K
Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
3.7K
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
445
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
445


