TACE联合抗血管生成药及PD-1抑制剂治疗中晚期肝癌的有效性和安全性

摘要/Abstract

摘要： 目的探讨经动脉化疗栓塞术(TACE)联合抗血管生成药的基础上加用程序性死亡受体-1(PD-1)抑制剂治疗中晚期肝细胞癌(HCC)的有效性和安全性。方法收集分析2018年6月至2020年10月在西京医院接受TACE＋抗血管生成药+PD-1抑制剂治疗的中晚期HCC患者。收集患者的临床资料,分析客观缓解率(ORR)、疾病控制率(DCR)、无进展生存期(PFS)、总生存期(OS)及相关不良反应(AE),探讨联合治疗的有效性和安全性。结果共纳入35例HCC患者,至随访截止时间,死亡患者17例(48.6%),存活患者18例(51.4%)。患者的中位PFS为8.9月(95%CI:6.3~11.6),中位OS为16.1月(95%CI:11.4~20.9)。总体ORR为60％,疾病控制率(DCR)为85.7％。在接受治疗的35例患者中,9例(25.7%)患者发生2级以上不良反应,经过减少药量和给与对症处理后均好转。结论联合治疗对中晚期HCC患者有一定的治疗效果,且不良反应相对可控。

关键词: 肝细胞癌, TACE, PD-1抑制剂, 回顾性研究

Abstract: Objective To analyze the efficacy and safety of transarterial chemoembolization (TACE) combined with anti-angiogenic drugs and programmed death receptor-1 (PD-1) inhibitors in the treatment of intermediate/advanced hepatocellular carcinoma (HCC).Methods Patients treated with TACE + anti-angiogenic drugs + PD-1 inhibitors who were hospitalized in Department of Gastroenterology in Xijing hospital from June 2018 to October 2020 were enrolled. The basic clinical characteristics, objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS) and related adverse reactions (AEs) of the patients were collected to explore the efficacy and safety of combined treatment.Results A total of 35 patients were enrolled. At the end of follow-up, 17 patients (48.6%) had died and 18 patients (51.4%) were still alive. The median PFS was 8.9 months (95%CI: 6.3-11.6) and the median OS was 16.1 months (95%CI: 11.4-20.9). The overall ORR was 60.0% and the disease control rate (DCR) was 85.7%. Among the 35 patients who received treatment, 9 patients (25.7%) had adverse reactions (AEs) above grade two. The adverse reactions improved after reducing the dosage and/or receiving symptomatic treatment.Conclusion Combination therapy has a certain therapeutic effect on patients with intermediate/advanced HCC, and the adverse reactions are relatively controllable.

Key words: Hepatocellular carcinoma, Transarterial chemoembolization, PD-1 inhibitors, Retrospective study

丁晓鹏, 帖君, 余嘉豪, 任鹏伟, 宣国云, 马硕怡, 郭长存, 韩英, 周新民. TACE联合抗血管生成药及PD-1抑制剂治疗中晚期肝癌的有效性和安全性[J]. 肝脏, 2022, 27(3): 277-280.

DING Xiao-peng, TIE Jun, YU Jia-hao, REN Peng-wei, XUAN Guo-yun, MA Shuo-yi, GUO Chang-cun, HAN Ying, ZHOU Xin-min. Efficacy and safety of TACE combined with anti-angiogenic drugs and PD-1 inhibitors in the treatment of intermediate/advanced HCC[J]. Chinese Hepatolgy, 2022, 27(3): 277-280.

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