肝细胞癌患者的治疗模式和生存结果
Kelsey S Lau-Min1,2, Angela C Tramontano3, Franklin Iheanacho4
1Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston.
JAMA network open
|December 30, 2025
概括
肝细胞癌 (HCC) 治疗正在发展. 现在,阿特佐利祖马布-贝瓦齐祖马布和杜尔瓦卢马布-特里梅利穆马布是常见的第一线疗法,但很少有患者接受二线治疗,这表明需要更好的测序策略.
科学领域:
- 在瘤学瘤学.
- 肝细胞癌研究 肝细胞癌研究
- 临床实践模式 临床实践模式
背景情况:
- 自2017年以来,肝细胞癌 (HCC) 的治疗环境随着新的全身疗法而发生了重大变化.
- 这些先进疗法对HCC的最佳顺序仍然未确定.
- 关于目前HCC系统治疗的临床实践模式的数据有限.
研究的目的:
- 评估目前的治疗模式和HCC全身疗法序列.
- 评估与HCC不同系统治疗方法相关的生存结果.
- 分析一线和二线全身疗法在HCC患者的使用情况.
主要方法:
- 使用全国电子健康记录 (EHR) 衍生数据库进行的回顾性队列研究.
- 包括在2011年1月1日至2023年12月31日期间接受HCC全身治疗的成年患者.
- 分析一线全身治疗类型,整体存活率 (OS) 和无进展存活率 (PFS).
主要成果:
- 索拉费尼布最初是最常见的第一线疗法,后来被阿特佐利祖马布-贝瓦西祖马布和杜尔瓦卢马布-特雷利穆马布所超越.
- 平均生存期为8.1个月,与一线治疗类型没有显著关联.
- 与索拉费尼布相比,一线阿特佐利祖马布-贝瓦齐祖马布的治疗改善了PFS (HR,0.84;95%CI,0.71-0.99).
- 只有20.7%的队列接受了二线治疗.
结论:
- 现在,阿特佐利祖马布-贝瓦齐祖马布和杜尔瓦卢马布-特里梅利穆马布是HCC的流行一线治疗方法.
- 显著比例的HCC患者不会进行二线全身治疗.
- 进一步的研究至关重要,以建立最佳的治疗顺序,并改善患者从随后的治疗中获益.
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