Radioembolization plus Immune Checkpoint Inhibitor Therapy Compared with Radioembolization plus Tyrosine Kinase Inhibitor Therapy for the Treatment of Hepatocellular Carcinoma.

Autor:	Garcia-Reyes K; Division of Vascular and Interventional Radiology, Mount Sinai Hospital, New York. Electronic address: kirema.garcia-reyes@mountsinai.org., Gottlieb RA; Division of Vascular and Interventional Radiology, Mount Sinai Hospital, New York., Menon KM; Division of Vascular and Interventional Radiology, Mount Sinai Hospital, New York., Bishay V; Division of Vascular and Interventional Radiology, Mount Sinai Hospital, New York., Patel R; Division of Vascular and Interventional Radiology, Mount Sinai Hospital, New York., Patel R; Division of Vascular and Interventional Radiology, Mount Sinai Hospital, New York., Nowakowski S; Division of Vascular and Interventional Radiology, Mount Sinai Hospital, New York., Sung MW; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York., Marron TU; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York., Gansa WH; Division of Vascular and Interventional Radiology, Mount Sinai Hospital, New York., Zhang J; Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York., Raja SC; Department of Vascular and Interventional Radiology, Rush University Medical Center, Illinois., Shilo D; Division of Vascular and Interventional Radiology, Mount Sinai Hospital, New York., Fischman A; Division of Vascular and Interventional Radiology, Mount Sinai Hospital, New York., Lookstein R; Division of Vascular and Interventional Radiology, Mount Sinai Hospital, New York., Kim E; Division of Vascular and Interventional Radiology, Mount Sinai Hospital, New York.
Jazyk:	angličtina
Zdroj:	Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2024 May; Vol. 35 (5), pp. 722-730.e1. Date of Electronic Publication: 2024 Feb 09.
DOI:	10.1016/j.jvir.2024.02.004
Abstrakt:	Purpose: To investigate if combination therapy with immune checkpoint inhibitor (ICI) and yttrium-90 ( 90 Y) radioembolization results in superior outcomes than those yielded by tyrosine kinase inhibitor (TKI) therapy and 90 Y for the treatment of intermediate- to advanced-stage hepatocellular carcinoma (HCC). Methods: A retrospective review of patients presented at an institutional multidisciplinary liver tumor board between January 1, 2012 and August 1, 2023 was conducted. In total, 44 patients with HCC who underwent 90 Y 4 weeks within initiation of ICI or TKI therapy were included. Propensity score matching was conducted to account for baseline demographic differences. Kaplan-Meier analysis was used to compare median progression-free survival (PFS) and overall survival (OS), and univariate statistics identified disease response and control rate differences. Duration of imaging response was defined as number of months between the first scan after therapy and the first scan showing progression as defined by modified Response Evaluation Criteria in Solid Tumors (mRECIST) or immune Response Evaluation Criteria in Solid Tumors (iRECIST). Adverse events were analyzed per Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Results: Patients in the 90 Y+ICI therapy group had better objective response rates (ORRs) (89.5% vs 36.8%; P < .001) and disease control rates (DCRs) (94.7% vs 63.2%; P < .001) by mRECIST and iRECIST (ORR: 78.9% vs 36.8%; P < .001; DCR: 94.7% vs 63.2%; P < .001). Median PFS (8.3 vs 4.1 months; P = .37) and OS (15.8 vs 14.3 months; P = .52) were not statistically different. Twelve patients (63.1%) in the 90 Y+TKI group did not complete systemic therapy owing to adverse effects compared with 1 patient (5.3%) in the 90 Y+ICI group (P < .001). Grade 3/4 adverse events were not statistically different ( 90 Y+TKI: 21.1%; 90 Y+ICI: 5.3%; P = .150). Conclusions: Patients with HCC who received 90 Y+ICI had better imaging response and fewer regimen-altering adverse events than those who received 90 Y+TKI. No significant combination therapy adverse events were attributable to radioembolization. (Copyright © 2024 SIR. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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