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Hepatic artery infusion chemotherapy combined with camrelizumab plus rivoceranib for hepatocellular carcinoma with portal vein tumor thrombosis: a multicenter propensity score-matching analysis.
Li, Yangyang; Guo, Jiandong; Liu, Wendao; Pang, Huajin; Song, Yipei; Wu, Siyi; Zhang, Fengtao; Yan, Dong; Chen, Junwei; An, Chao; Li, Chengzhi.
Afiliação
  • Li Y; Department of Interventional Radiology and Vascular Surgery, The First Affiliated Hospital of Jinan University, No.613 of West Huangpu Avenue, Guangzhou, Guangdong, 510630, People's Republic of China.
  • Guo J; Department of Interventional Radiology and Vascular Surgery, The First Affiliated Hospital of Jinan University, No.613 of West Huangpu Avenue, Guangzhou, Guangdong, 510630, People's Republic of China.
  • Liu W; Department of Interventional Therapy, Guangdong Provincial Hospital of Chinese Medicine and Guangdong Provincial Academy of Chinese Medical Sciences, No. 111 Dade Road, 510080, Guangzhou, Guangdong, People's Republic of China.
  • Pang H; Division of Vascular and Interventional Radiology, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, People's Republic of China.
  • Song Y; Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
  • Wu S; Department of Interventional Radiology and Vascular Surgery, The First Affiliated Hospital of Jinan University, No.613 of West Huangpu Avenue, Guangzhou, Guangdong, 510630, People's Republic of China.
  • Zhang F; Department of Interventional Therapy, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, Guangdong, China.
  • Yan D; Department of Oncology, Beijing Luhe Hospital, Capital Medical University, Beijing, 101199, China.
  • Chen J; Department of Interventional Radiology, The Third Affiliated Hospital of Sun Yat-Sen University, Tianhe Road 600#, Tianhe District, Guangzhou, 510630, Guangdong, People's Republic of China.
  • An C; Department of Minimal Invasive Intervention, Sun Yat-Sen University Cancer CenterState Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer Medicine, 651, Dongfeng East Road, Guangzhou, People's Republic of China. anchao-1983@163.com.
  • Li C; Department of Interventional Radiology and Vascular Surgery, The First Affiliated Hospital of Jinan University, No.613 of West Huangpu Avenue, Guangzhou, Guangdong, 510630, People's Republic of China. lichengzhi@jnu.edu.cn.
Hepatol Int ; 2024 May 08.
Article em En | MEDLINE | ID: mdl-38717693
ABSTRACT

BACKGROUND:

Portal vein tumor thrombosis (PVTT) signifies late-stage hepatocellular carcinoma (HCC) with high-risk progression and poor prognosis. As a standard treatment, sorafenib monotherapy has limited the efficacy in managing HCC with PVTT. Currently, both hepatic arterial infusion chemotherapy (HAIC) and the combination of camrelizumab and rivoceranib have shown favorable survival benefits for advanced HCC, surpassing the standard sorafenib treatment. In this study, we investigate the safety and efficacy of HAIC combined with camrelizumab and rivoceranib in treating HCC patients with PVTT.

METHODS:

From January 2020 to December 2021, HCC patients with PVTT, who received either a triple regime of HAIC combined with camrelizumab and rivoceranib or a dual regime of camrelizumab and rivoceranib as their first-line treatment, were reviewed for eligibility at four hospital centers in China. To balance any intergroup differences, propensity score matching (PSM) was applied. The aim of this study is to compare the efficacy of the dual and triple combination treatment regimens based on survival prognosis and tumor response and evaluate the safety based on the occurrence of adverse reactions.

RESULT:

In this study, a total of 411 patients who received either the triple treatment regime (HAIC combined with camrelizumab plus rivoceranib, referred to as the HAICCR group, n = 292) or the dual treatment regime (camrelizumab combined with rivoceranib, referred to as the CR group, n = 119) between January 2020 and December 2021 were included. The results showed that the HAICCR group exhibited significantly better overall survival (mOS 19.60 months vs. 11.50 months, p < 0.0001) and progression-free survival (mPFS 10.0 months vs. 5.6 months, p < 0.0001) compared to the CR group in the overall cohort. Moreover, the HAICCR group also had a significantly higher ORR (objective response rate, 55.5% vs. 42.0%, p = 0.013) and DCR (disease control rate, 89.0% vs. 79.0%) compared to the CR group. After PSM, a final matched cohort of 83 pairs was obtained, and the survival benefits were consistent in this cohort as well (mOS 18.70 months vs. 11.0 months, p < 0.0001; mPFS 10.0 months vs. 5.6 months, p < 0.0001). However, there was no significant difference in the ORR between the triple and dual combination regimes. Univariate and multivariate analysis showed that CTP (Child-Turcotte-Pugh) stage, ALBI (albumin-bilirubin index) grade, tumor number, and treatment regime were significant risk factors affecting overall survival, while AFP (α-fetoprotein) level, tumor number, metastasis, and treatment regime were significant risk factors affecting progression-free survival. As for safety, hypertension and hand-foot syndrome were the two most common adverse reactions in both groups, with no significant difference in the occurrence of adverse reactions between the two groups (p < 0.05).

CONCLUSION:

In the context of advanced HCC patients with PVTT, the combination regime of HAIC and camrelizumab plus rivoceranib demonstrates more excellent capacity for prolonging survival and offers a well-tolerated safety compared to the CR dual therapy approach. This triple regime represents a therapeutic modality of broad prospects and vast potential for HCC patients with PVTT.
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Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article