针对高级HCC的两种一线ICI治疗方案的比较有效性:使用电子医疗记录网络的目标试验模拟
Chihiro Shiraishi1, Miho Shigyou1, Ryuichi Inoue2
1Department of Pharmaceutical Sciences for Health Crisis Management, Faculty of Pharmaceutical Sciences, Fukuoka University, Fukuoka, Japan.
Frontiers in oncology
|February 9, 2026
概括
阿特佐利祖马布加贝瓦西祖马布 (Atezo+Bev) 和特雷米利穆马布加杜尔瓦卢马布 (Treme+Dur) 显示,对于晚期肝细胞癌的长期存活率相似. Atezo+Bev早期肝脏免疫相关不良事件较少,而Treme+Dur较早发生呼吸系统事件.
科学领域:
- 肝细胞癌研究 肝细胞癌研究
- 在瘤学中的免疫疗法.
- 现实世界的证据研究研究.
背景情况:
- 在先进的HCC中,对于阿特佐利祖马布加贝瓦齐祖马布 (Atezo+Bev) 与特里梅利穆马布加杜尔瓦卢马布 (Treme+Dur) 的对比数据有限.
- 在指导一线治疗决策时,现实世界的比较有效性和安全性数据至关重要.
研究的目的:
- 为了比较Atezo+Bev和Treme+Dur作为先进HCC的第一线治疗方法的真实世界疗效和安全性.
- 在两种治疗方案之间评估整体存活率 (OS) 和免疫相关不良事件 (irAEs).
主要方法:
- 使用TriNetX研究网络的目标试验仿真方法.
- 包括患有HCC的成年患者进行一线Atezo+Bev或Treme+Dur治疗.
- 倾向性得分匹配 (1:1) 以平衡基线特征,以OS和irAEs作为主要和次要结果.
主要成果:
- 一年后的OS在Atezo+Bev的数量上更高 (61%对55%,p=0.027).
- 整体生存期和2年生存期在各组之间没有显著差异 (中位数生存期:19.4个月与19.0个月).
- Atezo+Bev显示出较少的肝脏irrAEs (p=0.020) 的趋势,而Treme+Dur更早出现了呼吸道irrAEs (p=0.031).
结论:
- Atezo+Bev和Treme+Dur在现实世界HCC治疗中展示了可比的长期操作系统.
- 治疗方案可能会影响特定的irrAEs的出现,特别是肝脏和呼吸系统事件.
- 建议密切监测irAEs,特别是在Treme+Dur治疗时.
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