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Transarterial chemoembolization with/without immune checkpoint inhibitors plus tyrosine kinase inhibitors for unresectable hepatocellular carcinoma: a single center, propensity score matching real-world study
被引:2
|作者:
Yuan, Guosheng
[1
]
Li, Wenli
[1
]
Zang, Mengya
[1
]
Li, Rong
[1
]
Li, Qi
[1
]
Hu, Xiaoyun
[1
]
Zhang, Qi
[1
]
Huang, Wei
[2
]
Ruan, Jian
[3
]
Pang, Huajin
[4
]
Chen, Jinzhang
[1
]
机构:
[1] Southern Med Univ, Nanfang Hosp, Dept Infect Dis, State Key Lab Organ Failure Res, Guangzhou 510515, Guangdong, Peoples R China
[2] Southern Med Univ, Shunde Hosp, Dept Oncol, Shunde 528300, Guangdong, Peoples R China
[3] Zhejiang Univ, Affiliated Hosp 1, Sch Med, Dept Med Oncol, Hangzhou 310003, Zhejiang, Peoples R China
[4] Southern Med Univ, Nanfang Hosp, Dept Gen Surg, Div Vasc & Intervent Radiol, Guangzhou 510515, Guangdong, Peoples R China
基金:
中国国家自然科学基金;
关键词:
Hepatocellular carcinoma;
TACE;
Immune checkpoint inhibitors;
Tyrosine kinase inhibitors;
Overall survival;
MICROENVIRONMENT;
BEVACIZUMAB;
SORAFENIB;
TACE;
D O I:
10.1007/s12672-024-00917-1
中图分类号:
R73 [肿瘤学];
学科分类号:
100214 ;
摘要:
Objectives To explore the efficacy and safety of Transarterial chemoembolization (TACE) in combination with immune checkpoint inhibitors (ICIs) and tyrosine kinase inhibitors (TKIs) in patients with unresectable hepatocellular carcinoma (uHCC). Methods 456 patients with HCC receiving either TACE in combination with ICIs and TKIs (combination group, n = 139) or TACE monotherapy (monotherapy group, n = 317) were included from Apr 2016 to Dec 2021 in this retrospective study. We employed propensity score matching (PSM), performed 1:2 optimal pair matching, to balance potential bias. Results The mean follow-up time is 24.7 months (95% CI 22.6-26.8) for matched patients as of March 2022. After matching, the combination group achieved longer OS and PFS (median OS:21.9 vs. 16.3 months, P = 0.022; median PFS: 8.3 vs. 5.1 months, P < 0.0001) than TACE monotherapy group. The combination group had better objective response rate (ORR) and disease control rate (DCR) (ORR: 52.5% vs. 32.8%, P < 0.001; DCR: 82.7% vs. 59.6%, P < 0.001). Subgroup analysis showed that patients who received "TKIs + ICIs" after the first TACE procedure (after TACE group) achieved longer OS than those before the first TACE procedure (before TACE group) (26.8 vs. 19.2 months, P = 0.011). Adverse events were consistent with previous studies of TACE-related trials. Conclusions TACE plus TKIs and ICIs appeared to deliver longer PFS and OS in HCC patients than TACE monotherapy. "TKIs + ICIs" co-treatment within 3 months after the first TACE procedure might be a better medication strategy.
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