| 江 毅,舒明志,姚 征,等.经动脉化疗栓塞联合免疫检查点抑制剂及血管内皮生长因子或酪氨酸激酶抑制剂治疗肝细胞癌：一项双中心对照研究[J].肿瘤学杂志,2025,31(4):311-318. |
| 经动脉化疗栓塞联合免疫检查点抑制剂及血管内皮生长因子或酪氨酸激酶抑制剂治疗肝细胞癌：一项双中心对照研究 |
| Transarterial Chemoembolization Combined with Immune Checkpoint Inhibitors plus Vascular Endothelial Growth Factor or Tyrosine Kinase Inhibitor in Hepatocellular Carcinoma： A Dual-Center Controlled Study |
| 投稿时间：2025-01-02 |
| DOI：10.11735/j.issn.1671-170X.2025.04.B006 |
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| 中文关键词: 肝细胞癌 经导管动脉化疗栓塞 血管内皮生长因子受体 受体酪氨酸激酶 免疫检查点抑制剂 |
| 英文关键词:hepatocellular carcinoma transarterial chemoembolization vascular endothelial growth factor tyrosine kinases inhibitor immune checkpoint inhibitor |
| 基金项目:浙江省基础公益研究计划自然科学基金探索项目（LTGY24H180014）；浙江省中医药科技计划项目（2023ZL295）；浙江省医药卫生科技计划项目（2022KY118，2023KY600，2023KY618，2024KY811，2025KY688） |
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| 中文摘要: |
| 摘 要：［目的］ 比较经动脉化疗栓塞（transarterial chemoembolization，TACE）联合免疫检查点抑制剂（immune checkpoint inhibitor，ICI）及血管内皮生长因子或酪氨酸激酶抑制剂治疗不可切除肝细胞癌（hepatocellular carcinoma，HCC）的疗效和安全性。［方法］ 回顾性收集2021年1月至2023年6月期间接受TACE联合ICI及贝伐珠单抗［TACE+ICI+bevacizumab（BEV）］（n=31）或仑伐替尼［TACE+ICI+lenvatinib（LEN）］（n=33）治疗的64例不可切除HCC患者的数据。主要研究终点为无进展生存期（progression-free survival ，PFS）及总生存期（overall survival，OS），次要研究终点包括肿瘤反应、手术转化率及安全性。［结果］ TACE+ICI+BEV组与TACE+ICI+LEN组的中位PFS分别为5.7个月和4.9个月（P=0.404）；中位OS分别为21.3个月和未达到。TACE+ICI+BEV组的患者手术转化率更高（22.6% vs 3.0%，P=0.047）。丙氨酸转氨酶≤40 U/L（P=0.039）以及无肝血管侵犯（P=0.044）的患者从TACE+ICI+BEV中获益更多。Child-Pugh 评分为A级的患者对两种治疗方案均表现出更好的反应（P=0.002）。［结论］ TACE+ICI+BEV疗法能显著提高中晚期和复发性不可切除HCC患者的手术转化率。肝功能较好的患者疗效更佳。 |
| 英文摘要: |
| Abstract：［Objective］ To compare the efficacy and safety of transarterial chemoembolization (TACE) combined with immune checkpoint inhibitors (ICI) and vascular endothelial growth factor or tyrosine kinase inhibitor in unresectable hepatocellular carcinoma (HCC). ［Methods］ Clinical data of 64 patients with unresectable HCC who received either TACE combined with ICIs plus bevacizumab (TACE+ICI+BEV) (n=31) or lenvatinib (TACE+ICI+LEN) (n=33) between January 2021 and June 2023 were retrospective analyzed. The primary outcomes were progression-free survival (PFS) and overall survival (OS)， while secondary outcomes included tumor response， conversion rates and safety. ［Results］ The median PFS of TACE+ICI+BEV group and TACE+ICI+LEN group was 5.7 months and 4.9 months， respectively (P=0.404)， and the median OS was 21.3 months and not reached. The surgical conversion rate of patients in the TACE+ICI+BEV group was higher (22.6% vs 3.0%， P=0.047). Patients with alanine aminotransferase ≤40 U/L (P=0.039) and no hepatic vascular invasion (P=0.044) benefited more from the TACE+ICI+BEV. In addition， patients with a Child-Pugh class A had better response to both therapies (P=0.002). ［Conclusion］ TACE+ICI+BEV therapy demonstrates notable potential in increasing surgical conversion rate of patients with intermediate to advanced or recurred unresectable HCC， suggesting enhanced outcomes particularly in patients with superior liver function. |
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