UNASSIGNED: We retrospectively analyzed patients with hepatitis B virus (HBV)-associated advanced HCC who underwent ICIs combination therapy from January 1, 2020, to December 30, 2022. Patients were stratified into PPI and non-PPI groups based on whether they received PPI treatment within 30 days before or after ICIs therapy. Patients\' survival and the risk of PPI-associated mortality was assessed. Adverse events were also evaluated.
UNASSIGNED: A total of 183 patients with HBV-associated HCC treated with ICI combination therapy were included. The median survival time (12.5 months vs 13.7 months, P = 0.285) and incidence of adverse events (P = 0.729) did not significantly differ between the PPI and non-PPI groups. Even after propensity score matching, the difference in median overall survival (OS) between the two groups was not significant (10.7 months vs 11.4 months; P = 0.596) and the patient\'s OS is not significantly related to the dosage of PPI application (P > 0.05).However, according to our subgroup analysis, among HCC patients with a serum HBV DNA concentration ≥ 200 IU/mL, the use of PPIs significantly increased the risk of mortality in patients receiving ICI combination therapy (P = 0.024).
UNASSIGNED: PPIs do not notably influence the survival prognosis of patients receiving ICI combination therapy for HBV-associated advanced HCC. However, among patients with high levels of HBV DNA, PPIs increase the risk of mortality. Therefore, antiviral therapy should be intensified in the patients with HBVDNA > 200 IU/mL. Additionally, PPIs do not impact the incidence of adverse reactions in these patients.
■我们回顾性分析了从2020年1月1日至2022年12月30日接受ICIs联合治疗的乙型肝炎病毒(HBV)相关晚期HCC患者。根据患者是否在ICIs治疗前或后30天内接受PPI治疗,将患者分为PPI组和非PPI组。评估患者的生存率和PPI相关死亡风险。还评估了不良事件。
■共有183例HBV相关HCC患者接受ICI联合治疗。中位生存时间(12.5个月vs13.7个月,PPI组和非PPI组之间P=0.285)和不良事件发生率(P=0.729)无显著差异。即使在倾向得分匹配之后,两组患者的中位总生存期(OS)差异不显著(10.7个月vs11.4个月;P=0.596),患者的OS与PPI应用剂量无显著相关性(P>0.05)。然而,根据我们的亚组分析,在血清HBVDNA浓度≥200IU/mL的HCC患者中,PPI的使用显著增加了ICI联合治疗患者的死亡风险(P=0.024).
■PPI不会显着影响接受ICI联合治疗的HBV相关晚期HCC患者的生存预后。然而,在HBVDNA水平高的患者中,PPI增加死亡风险。因此,HBVDNA>200IU/mL的患者应加强抗病毒治疗。此外,PPI不会影响这些患者的不良反应发生率。