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TACE联合仑伐替尼及PD-1单抗治疗中晚期肝细胞癌的疗效及安全性分析
Clinical efficacy and safety of TACE combined with lenvatinib and PD-1 antibody in treatment of intermediate-advanced hepatocellular carcinoma
- 陆军军医大学学报 2024年46卷第22期 页码：2529-2538
- 作者机构：
400038 重庆，陆军军医大学(第三军医大学)第一附属医院肝胆外科
- 作者简介：
[张雷达，E-mail: 2518569931@qq.comZHANG Leida, E-mail: 2518569931@qq.com
- 基金信息：重庆市博士“直通车”科研项目(CSTB2022BSXM-JCX0004);重庆市科卫联合医学科研项目(2022QNXM020);重庆市自然科学基金面上项目(cstc2021jcyj-msxmX1018)
DOI：10.16016/j.2097-0927.202405116
中图分类号： R181.23;R730.53;R735.7收稿：2024-05-30，
修回：2024-06-28，
纸质出版：2024-11-30
- 稿件说明：
移动端阅览
蒋家云, 张辉, 张诗育, 等. TACE联合仑伐替尼及PD-1单抗治疗中晚期肝细胞癌的疗效及安全性分析[J]. 陆军军医大学学报, 2024,46(22):2529-2538.
Jiayun JIANG, Hui ZHANG, Shiyu ZHANG, et al. Clinical efficacy and safety of TACE combined with lenvatinib and PD-1 antibody in treatment of intermediate-advanced hepatocellular carcinoma[J]. Journal of Army Medical University, 2024, 46(22): 2529-2538.
蒋家云, 张辉, 张诗育, 等. TACE联合仑伐替尼及PD-1单抗治疗中晚期肝细胞癌的疗效及安全性分析[J]. 陆军军医大学学报, 2024,46(22):2529-2538. DOI： 10.16016/j.2097-0927.202405116.
Jiayun JIANG, Hui ZHANG, Shiyu ZHANG, et al. Clinical efficacy and safety of TACE combined with lenvatinib and PD-1 antibody in treatment of intermediate-advanced hepatocellular carcinoma[J]. Journal of Army Medical University, 2024, 46(22): 2529-2538. DOI： 10.16016/j.2097-0927.202405116.
摘要
目的
2
分析经肝动脉化疗栓塞(transcatheter arterial chemoembolization
TACE)联合仑伐替尼及PD-1单抗的三联疗法治疗中晚期肝细胞癌(hepatocellular carcinoma，HCC)的疗效和安全性。
方法
2
本项目是一项回顾性队列研究。收集2021年1月至2023年6月陆军军医大学第一附属医院肝胆外科收治的105例行TACE联合仑伐替尼及PD-1单抗治疗的中晚期HCC患者的临床资料，收集患者TACE术前和术后随访的血生化指标及影像学特征，统计客观缓解率(objective response rate，ORR)、疾病控制率(disease control rate，DCR)、转化切除率、总生存期(overall survival
OS) 和无进展生存期(progression-free survival
PFS) 等指标评价三联疗法的临床疗效，记录治疗过程中出现的所有不良反应的频率及严重程度以评估三联疗法的安全性。
结果
2
105例接受三联治疗的中晚期HCC患者有33例死亡，72例仍存活。ORR为62.8%，DCR为72.3%，转化切除率为11.4%。中位总生存期(median overall survival
mOS)未达到。中位无进展生存期(median progression-free survival
mPFS)为(10.3±0.8)个月。所有等级不良反应发生率为97.1%，3~4级不良反应发生率为33.3%，无治疗相关的死亡病例发生。
结论
2
TACE联合仑伐替尼及PD-1单抗的三联疗法是一种安全、有效的综合治疗方案，为改善中晚期肝细胞癌的预后提供了新的治疗策略。
Abstract
Objective
2
To analyze the clinical efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with lenvatinib and PD-1 antibody in the treatment of intermediate-advanced hepatocellular carcinoma (HCC).
Methods
2
A retrospective cohort trial was conducted on 105 patients with intermediate-advanced HCC (BCLC B or C stage) treated with TACE combined with lenvatinib and PD-1 antibody in our institute from January 2021 to June 2023. The blood biochemical indicators and imaging characteristics of the patients were collected before and after TACE. Objective response rate (ORR)
disease control rate (DCR)
conversion resection rate
overall survival (OS) and progression-free survival (PFS) were analyzed to evaluate the clinical efficacy of the triple therapy
and the frequency and severity of all adverse reactions during treatment were recorded to evaluate the safety of the therapy.
Results
2
Among the 105 patients with intermediate-advanced HCC who received triple therapy
33 died and 72 survived. The ORR was 62.8% and the DCR was 72.3%. The conversion resection rate was 11.4%. The median OS (mOS) was not reached. The median PFS (mPFS) was (10.3±0.8) months. The incidence of adverse reactions of all grades was 97.1%
and the incidence of those of grade 3~4 was 33.3%. No treatment-related death occurred.
Conclusion
2
The triple therapy of TACE combined with lenvatinib and PD-1 antibody is a safe and effective comprehensive treatment regimen
which provides a new treatment strategy for improving the prognosis of intermediate-advanced HCC.
关键词
Keywords
references
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