背景:肝细胞癌(HCC)是一种高度侵袭性的肿瘤,具有显著的发病率和死亡率。近年来,免疫检查点抑制剂(ICIs)和激酶抑制剂的联合治疗已成为肝癌治疗的有希望的策略。然而,预测晚期肝癌患者联合治疗结局的临床因素仍不确定.因此,这项研究调查了临床预测因子与ICI联合激酶抑制剂治疗的疗效之间的关系,以制定个性化治疗计划.
方法:我们回顾性招募了98例接受ICIs和激酶抑制剂联合治疗的晚期HCC患者。根据治疗前的血脂水平和其他临床因素,我们研究了可以预测该患者人群治疗反应的潜在生物标志物.
结果:该队列的平均无进展生存期(PFS)和总生存期(OS)分别为10.1和17.2个月,分别。通过多变量分析,没有肝外转移,没有门静脉血栓形成(PVT),中性粒细胞与淋巴细胞比值(NLR)<3.225,血小板与淋巴细胞比值(PLR)<140.75和预后营养指数(PNI)≥37.25被认为是PFS改善的独立预测因子.与更好的OS相关的因素包括PLR<140.75和总胆固醇(TC)<3.46mmol/L。单变量分析确定了东部肿瘤协作组表现状态(ECOGPS)的显著关联,乙型肝炎病毒(HBV)DNA水平,Child-Pugh分类,甲胎蛋白(AFP),TC,以及带有PFS的regorafenib收据。此外,ECOGPS,Child-Pugh分类,法新社,PVT,NLR,PNI,服用雷戈非尼与OS显著相关.
结论:PLR和TC是接受ICI/激酶抑制剂联合治疗的晚期HCC患者生存结局的潜在临床预测因素。重要的是在治疗开始之前了解患者的临床特征以优化结果。
BACKGROUND: Hepatocellular carcinoma (HCC) is a highly aggressive tumor associated with significant morbidity and mortality rates. Combination therapy with immune checkpoint inhibitors (ICIs) and kinase inhibitors has emerged as a promising strategy for liver cancer treatment in recent years. However, the clinical factors predicting the outcomes of combination therapy in patients with advanced liver cancer remain uncertain. Therefore, this study investigated the relationships between clinical predictors and the efficacy of ICI plus kinase inhibitor therapy to personalize treatment plans.
METHODS: We retrospectively enrolled 98 patients who received combination treatment with ICIs and kinase inhibitors for advanced HCC. Based on blood lipid levels and other clinical factors prior to treatment, we investigated potential biomarkers that could predict treatment responses in this patient population.
RESULTS: Mean progression-free survival (PFS) and overall survival (OS) in this cohort were 10.1 and 17.2 months, respectively. Via multivariate analysis, the absence of extrahepatic metastasis, the absence of portal vein thrombosis (PVT), neutrophil-to-lymphocyte ratio (NLR) < 3.225, platelet-to-lymphocyte ratio (PLR) < 140.75, and prognostic nutritional index (PNI) ≥ 37.25 were identified as independent predictors of improved PFS. Factors associated with better OS included PLR < 140.75 and total cholesterol (TC) < 3.46 mmol/L. Univariate analysis identified significant associations of Eastern Cooperative Oncology Group performance status (ECOG PS), hepatitis B virus (HBV) DNA levels, Child-Pugh classification, alpha-fetoprotein (AFP), TC, and the receipt of regorafenib with PFS. Additionally, ECOG PS, Child-Pugh classification, AFP, PVT, NLR, PNI, and the receipt of regorafenib were significantly associated with OS.
CONCLUSIONS: PLR and TC were potential clinical predictive factors for survival outcomes in patients with advanced HCC who received ICI/kinase inhibitor combination therapy. It is important to know the clinical characteristics of patients prior to treatment initiation to optimize outcomes.