PDF(Pubmed)
Abstract：
OBJECTIVE: The evidence of apatinib plus immune checkpoint inhibitors (ICIs) and transarterial chemoembolization (TACE) for treating advanced hepatocellular carcinoma (HCC) is limited. This study aimed to compare the treatment efficacy and safety of apatinib plus ICIs and TACE with apatinib plus TACE in these patients.
METHODS: This study retrospectively enrolled 90 patients with advanced HCC treated with apatinib plus TACE (A-TACE group, n = 52) or apatinib plus ICIs and TACE (IA-TACE group, n = 38).
RESULTS: The objective response rate was numerically higher in IA-TACE group compared with A-TACE group without statistical significance (57.9% vs. 36.5%, P = 0.055). Disease control rate was not different between groups (86.8% vs. 76.9%, P = 0.248). Progression-free survival (PFS) was improved in IA-TACE group compared with A-TACE group (P = 0.018). The median PFS (95% confidence interval) was 12.5 (8.7-16.3) months in IA-TACE group and 8.5 (5.6-11.4) months in A-TACE group. Overall survival (OS) was also prolonged in IA-TACE group compared with A-TACE group (P = 0.007). The median OS (95% confidence interval) was 21.1 (15.8-26.4) months in IA-TACE group and 14.3 (11.5-17.1) months in A-TACE group. By multivariate Cox regression model, IA-TACE was independently associated with prolonged PFS (hazard ratio = 0.539, P = 0.038) and OS (hazard ratio = 0.447, P = 0.025). Most adverse events were not different between groups. Only the incidence of reactive cutaneous capillary endothelial proliferation was higher in IA-TACE group compared with A-TACE group (10.5% vs. 0.0%, P = 0.029).
CONCLUSIONS: Apatinib plus ICIs and TACE may be an effective and safe treatment for patients with advanced HCC, but further large-scale studies are needed for verification.
METHODS: This study retrospectively enrolled 90 patients with advanced HCC treated with apatinib plus TACE (A-TACE group, n = 52) or apatinib plus ICIs and TACE (IA-TACE group, n = 38).
RESULTS: The objective response rate was numerically higher in IA-TACE group compared with A-TACE group without statistical significance (57.9% vs. 36.5%, P = 0.055). Disease control rate was not different between groups (86.8% vs. 76.9%, P = 0.248). Progression-free survival (PFS) was improved in IA-TACE group compared with A-TACE group (P = 0.018). The median PFS (95% confidence interval) was 12.5 (8.7-16.3) months in IA-TACE group and 8.5 (5.6-11.4) months in A-TACE group. Overall survival (OS) was also prolonged in IA-TACE group compared with A-TACE group (P = 0.007). The median OS (95% confidence interval) was 21.1 (15.8-26.4) months in IA-TACE group and 14.3 (11.5-17.1) months in A-TACE group. By multivariate Cox regression model, IA-TACE was independently associated with prolonged PFS (hazard ratio = 0.539, P = 0.038) and OS (hazard ratio = 0.447, P = 0.025). Most adverse events were not different between groups. Only the incidence of reactive cutaneous capillary endothelial proliferation was higher in IA-TACE group compared with A-TACE group (10.5% vs. 0.0%, P = 0.029).
CONCLUSIONS: Apatinib plus ICIs and TACE may be an effective and safe treatment for patients with advanced HCC, but further large-scale studies are needed for verification.
摘要：
目的：阿帕替尼联合免疫检查点抑制剂（ICIs）和经动脉化疗栓塞（TACE）治疗晚期肝细胞癌（HCC）的证据有限。这项研究旨在比较阿帕替尼联合ICIs和TACE与阿帕替尼联合TACE在这些患者中的疗效和安全性。
方法：本研究回顾性纳入了90例接受阿帕替尼联合TACE治疗的晚期HCC患者（A-TACE组，n=52)或阿帕替尼+ICIs和TACE(IA-TACE组，n=38）。
结果：与A-TACE组相比，IA-TACE组的客观缓解率在数值上较高，无统计学意义（57.9％vs.36.5%,P=0.055)。组间疾病控制率无差异（86.8%vs.76.9%,P=0.248）。与A-TACE组相比，IA-TACE组的无进展生存期（PFS）提高（P=0.018）。IA-TACE组的中位PFS（95％置信区间）为12.5（8.7-16.3）个月，A-TACE组为8.5（5.6-11.4）个月。与A-TACE组相比，IA-TACE组的总生存期（OS）也延长（P=0.007）。IA-TACE组的中位OS（95％置信区间）为21.1（15.8-26.4）个月，A-TACE组为14.3（11.5-17.1）个月。通过多元Cox回归模型，IA-TACE与延长的PFS（风险比=0.539，P=0.038）和OS（风险比=0.447，P=0.025）独立相关。大多数不良事件在组间没有差异。与A-TACE组相比，IA-TACE组只有反应性皮肤毛细血管内皮增生的发生率更高（10.5％vs.0.0%,P=0.029)。
结论：阿帕替尼联合ICIs和TACE治疗晚期肝癌可能是一种安全有效的治疗方法。但需要进一步的大规模研究进行验证。
方法：本研究回顾性纳入了90例接受阿帕替尼联合TACE治疗的晚期HCC患者（A-TACE组，n=52)或阿帕替尼+ICIs和TACE(IA-TACE组，n=38）。
结果：与A-TACE组相比，IA-TACE组的客观缓解率在数值上较高，无统计学意义（57.9％vs.36.5%,P=0.055)。组间疾病控制率无差异（86.8%vs.76.9%,P=0.248）。与A-TACE组相比，IA-TACE组的无进展生存期（PFS）提高（P=0.018）。IA-TACE组的中位PFS（95％置信区间）为12.5（8.7-16.3）个月，A-TACE组为8.5（5.6-11.4）个月。与A-TACE组相比，IA-TACE组的总生存期（OS）也延长（P=0.007）。IA-TACE组的中位OS（95％置信区间）为21.1（15.8-26.4）个月，A-TACE组为14.3（11.5-17.1）个月。通过多元Cox回归模型，IA-TACE与延长的PFS（风险比=0.539，P=0.038）和OS（风险比=0.447，P=0.025）独立相关。大多数不良事件在组间没有差异。与A-TACE组相比，IA-TACE组只有反应性皮肤毛细血管内皮增生的发生率更高（10.5％vs.0.0%,P=0.029)。
结论：阿帕替尼联合ICIs和TACE治疗晚期肝癌可能是一种安全有效的治疗方法。但需要进一步的大规模研究进行验证。
