Association of hepatitis B virus DNA levels with efficacy and safety outcomes in patients with hepatitis B virus-associated advanced hepatocellular carcinoma receiving tyrosine kinase inhibitor plus anti-PD-1 antibody: a multicenter propensity-matched study

被引：4

作者：

Chen, Qing-Jing ^{[1
,2
]}

Lin, Kong-Ying ^{[1
,2
]}

Lin, Zhi-Wen ^{[1
,2
]}

Zhang, Bing ^{[1
]}

Liu, Ming-Qiang ^{[3
]}

Zhang, Jian-Xi ^{[4
]}

Lin, Ke-Can ^{[1
,2
]}

Huang, Qi-Zhen ^{[5
]}

Zhang, Jin-Yu ^{[1
]}

You, Peng-Hui ^{[7
]}

You, Song ^{[1
]}

Wei, Fu-Qun ^{[6
]}

Jiang, Ya-Bin ^{[1
]}

Zhang, Hui ^{[8
]}

Cheng, Zhi-Qing ^{[9
]}

Wang, Cong-Ren ^{[10
]}

Zeng, Yong-Yi ^{[1
,2
]}

机构：

[1] Fujian Med Univ, Dept Hepatopancreatobiliary Surg, Mengchao Hepatobiliary Hosp, Fuzhou 350025, Peoples R China

[2] Fujian Med Univ, Dept Hepatopancreatobiliary Surg, Affiliated Hosp 1, Fuzhou 350000, Peoples R China

[3] Fujian Med Univ, Dept Intervent Radiol, Zhangzhou Affiliated Hosp, Zhangzhou, Peoples R China

[4] Beijing Univ Chinese Med, Xiamen Hosp, Dept Hepatobiliary Surg, Xiamen 361000, Peoples R China

[5] Fujian Med Univ, Dept Radiat Oncol, Mengchao Hepatobiliary Hosp, Fuzhou 350000, Peoples R China

[6] Fujian Med Univ, Dept Intervent Radiol, Affiliated Hosp 1, Fuzhou 350000, Peoples R China

[7] Fujian Med Univ, Mengchao Hepatobiliary Hosp, Biobank, Fuzhou 350000, Peoples R China

[8] Fujian Med Univ, Dept Hepatopancreatobiliary Surg, Canc Hosp, Fuzhou 350000, Peoples R China

[9] Putian Univ, Affiliated Hosp, Dept Gen Surg, Putian 351100, Peoples R China

[10] Fujian Med Univ, Dept Hepatobiliary Surg, Quanzhou Hosp 1, Quanzhou 362000, Peoples R China

来源：

INTERNATIONAL IMMUNOPHARMACOLOGY | 2023年 / 125卷

基金：

中国国家自然科学基金;

关键词：

Hepatocellular carcinoma; Hepatitis B virus; Prognosis; Tyrosine kinase inhibito; alpha-PD1; Programmed death-1; SORAFENIB; THERAPY; BEVACIZUMAB; LENVATINIB; MORTALITY; SURVIVAL; EVENTS; BLIND;

D O I：

10.1016/j.intimp.2023.111098

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background: The efficacy and safety of tyrosine kinase inhibitors (TKIs) combined with anti-PD-1 antibodies (alpha-PD-1) in advanced hepatocellular carcinoma (HCC) with high hepatitis B virus (HBV) DNA levels (>500 IU/ mL) remain unclear.Methods: We retrospectively assessed patients from seven medical institutions diagnosed with HBV-related HCC, undergoing treatment with TKIs and alpha-PD-1 in conjunction with antiviral therapies. Based on HBV-DNA levels, patients were categorized into either high (HHBV-DNA, >500 IU/mL) or low HBV-DNA (LHBV-DNA, <500 IU/ mL) cohorts Propensity score matching (PSM) was used to minimize baseline imbalance between groups.Results: 149 patients were included, with 66 patients exhibiting HBV-DNA > 500 IU/mL and 83 patients presenting HBV-DNA < 500 IU/mL. Compared with the LHBV-DNA cohort, the HHBV-DNA cohort had a greater incidence of serum HBeAg positivity, tumor diameter >= 10 cm, and vascular invasion. Following PSM, 57 individuals were enrolled in each group. Oncological outcomes were comparable between HHBV-DNA and LHBVDNA cohorts before and after PSM. Before PSM, the median PFS and OS were 6.1 months and 17.5 months in the HHBV-DNA cohort and 6.7 months and 19.3 months in the LHBV-DNA cohort (all P > 0.05). After PSM, the median PFS and OS were 6.0 months and 19.5 months in the HHBV-DNA cohort and 6.0 months and 17.1 months in the LHBV-DNA cohort, respectively (all P > 0.05). Safety profiles were equivalent across cohorts with no fatal incidents reported. Seven patients (4.7 %) had HBV reactivation.1 (0.7 %) from HHBV-DNA and 6 (4.0 %) from LHBV-DNA (P = 0.134). Only one patient developed HBV-related hepatitis.Conclusions: The effectiveness and safety of TKIs plus alpha-PD-1 in advanced HCC with HBV-DNA > 500 IU/mL were not compromised in the context of concomitant antiviral therapy.

引用

页数：10

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