Transarterial Chemoembolization Combined with Tyrosine Kinase Inhibitors Plus Immune Checkpoint Inhibitors Versus Tyrosine Kinase Inhibitors Plus Immune Checkpoint Inhibitors in Unresectable Hepatocellular Carcinoma with First- or Lower-Order Portal Vein Tumor Thrombosis.

Autor: Zhang JX; Department of Interventional Radiology, The First Affiliated Hospital With Nanjing Medical University, No. 300, Guangzhou Rd, Nanjing, 210029, China., Cheng Y; Department of Medical Oncology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210002, China., Wei J; Department of Oncology, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003, China., Fan WL; Department of Radiology, School of Medicine, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, 310020, China., Liu J; Department of Clinical Medicine Research Institution, The First Affiliated Hospital With Nanjing Medical University, Nanjing, 210029, China., Zhou CG; Department of Interventional Radiology, The First Affiliated Hospital With Nanjing Medical University, No. 300, Guangzhou Rd, Nanjing, 210029, China., Liu S; Department of Interventional Radiology, The First Affiliated Hospital With Nanjing Medical University, No. 300, Guangzhou Rd, Nanjing, 210029, China., Shi HB; Department of Interventional Radiology, The First Affiliated Hospital With Nanjing Medical University, No. 300, Guangzhou Rd, Nanjing, 210029, China., Chu XY; Department of Medical Oncology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210002, China. chuxiaoyuan000@163.com., Zheng WL; Department of Radiology, School of Medicine, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, 310020, China. weiliangzheng@zju.edu.cn., Zu QQ; Department of Interventional Radiology, The First Affiliated Hospital With Nanjing Medical University, No. 300, Guangzhou Rd, Nanjing, 210029, China. zuqingquan@njmu.edu.cn.
Jazyk: angličtina
Zdroj: Cardiovascular and interventional radiology [Cardiovasc Intervent Radiol] 2024 Jun; Vol. 47 (6), pp. 751-761. Date of Electronic Publication: 2024 Apr 26.
DOI: 10.1007/s00270-024-03724-x
Abstrakt: Purpose: To compare the efficacy of transarterial chemoembolization (TACE) combined with tyrosine kinase inhibitors (TKIs) plus immune checkpoint inhibitors (ICIs) (TACE-TKI-ICI) versus TKIs plus ICIs (TKI-ICI) for unresectable hepatocellular carcinoma (HCC) with first- or lower-order portal vein tumor thrombosis (PVTT).
Materials and Methods: A retrospective study was performed in HCC patients with first- or lower-order PVTT receiving TKIs (Lenvatinib or sorafenib) plus ICIs (camrelizumab, sintilimab, or atezolizumab) with or without TACE from four institutions between January 2019 and January 2022. Propensity score-based method was performed to minimize bias by confounding factors. Tumor response, progression-free survival (PFS), overall survival (OS), and adverse events (AEs) were evaluated and compared between the two groups.
Results: After inverse probability of treatment weighting, two balanced pseudopopulations were created: 106 patients in the TACE-TKI-ICI group and 109 patients in the TKI-ICI group. The objective response rate was higher in the TACE-TKI-ICI group (50.9% vs. 28.4%, P < 0.001). The median PFS and OS were significantly longer in the TACE-TKI-ICI group than in the TKI-ICI group (PFS: 9.1 vs. 5.0 months, P = 0.005; OS: 19.1 vs. 12.7 months, P = 0.002). In Cox regression, TACE-TKI-ICI treatment was an independent predictor of favorable OS. Treatment-related grade 3/4 AEs were comparable between the two groups (22.6% vs. 17.9%, P = 0.437).
Conclusion: TACE-TKI-ICI therapy contributed to better tumor control, PFS and OS than TKI-ICI therapy in unresectable HCC patients with first- or lower-order PVTT.
(© 2024. Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).)
Databáze: MEDLINE
Externí odkaz: