中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 40 Issue 3
Mar.  2024
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2024  >  40(3): 550-555

Efficacy and safety of transcatheter arterial chemoembolization combined with targeted therapy and immunotherapy in treatment of patients with stage Ⅱ‍b/Ⅲ‍a hepatocellular carcinoma based on China Liver Cancer Staging

DOI: 10.12449/JCH240318

  • Department of Interventional Radiology，The First Affiliated Hospital of Soochow University，Suzhou，Jiangsu 215000，China

Research funding:

Social Development Program of Jiangsu Province (BE2021648)

More Information
  • Corresponding author: ZHU Xiaoli， zhuxiaoli90@163.com （ORCID： 0000-0002-3507-2018）
  • Received Date: 2023-07-05
  • Accepted Date: 2023-08-11
  • Published Date: 2024-03-20
    Abstract
  •   Objective  To evaluate the efficacy and safety of first-line transcatheter arterial chemoembolization （TACE） combined with targeted therapy and immunotherapy in the treatment of patients with stage Ⅱb/Ⅲa hepatocellular carcinoma （HCC） based on China Liver Cancer Staging （CNLC）.  Methods  A total of 198 patients who received first-line TACE combined with targeted therapy and immunotherapy or received TACE alone from January 2015 to December 2022 in the First Affiliated Hospital of Soochow University were enrolled in this study， and after propensity score matching， there were 50 patients in combination group and 50 patients in TACE group. The Kaplan-Meier method was used to calculate median overall survival （mOS） and median progression-free survival （mPFS）. Modified Response Evaluation Criteria in Solid Tumors was used to evaluate objective response rate （ORR） and disease control rate （DCR）， and Common Terminology Criteria for Adverse Events v5.0 was used to evaluate adverse events. The chi-square test was used for comparison of categorical data between two groups； the t-test was used for comparison of normally distributed continuous data between two groups， and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between two groups. The Kaplan-Meier method was used to estimate survival time and calculate 95% confidence interval （CI）， and the Log-rank test was used for comparison of mOS and mPFS between two groups.  Results  The combination group had an mOS of 30.1 months （95%CI： 21.9‍ ‍—‍ ‍38.3）， and the TACE group had an mOS of 14.5 months （95%CI： 11.0 ‍—‍‍ ‍18.0）， with a significant difference between the two groups （χ2=17.8， P<0.001）； the combination group had an mPFS of 10.3 months （95%CI： 8.8‍ ‍—‍ ‍11.8）， and the TACE group had an mPFS of 7.1 months （95%CI： 5.8‍ — ‍8.4）， with a significant difference between the two groups （χ2=10.4， P<0.001）. There were significant differences between the combination group and the TACE group in ORR （84% vs 58%， P<0.05） and DCR （94% vs 80%， P<0.05）. There was no significant difference between the combination group and the TACE group in the incidence rate of adverse events （24% vs 16%， P=0.317）， and no adverse event-related deaths were observed in either group.  Conclusion  Compared with TACE alone， TACE combined with targeted therapy and immunotherapy has a better efficacy in the treatment of patients with CNLC stage Ⅱb/Ⅲa HCC， without increasing the incidence rate of severe adverse events.

     

    • FullText(HTML)
  • loading
    • References(21)
  • [1]
    VOGEL A, MEYER T, SAPISOCHIN G, et al. Hepatocellular carcinoma[J]. Lancet, 2022, 400( 10360): 1345- 1362. DOI: 10.1016/S0140-6736(22)01200-4.
    [2]
    PARK JW, CHEN M, COLOMBO M, et al. Global patterns of hepatocellular carcinoma management from diagnosis to death: the BRIDGE Study[J]. Liver Int, 2015, 35( 9): 2155- 2166. DOI: 10.1111/liv.12818.
    [3]
    OGASAWARA S, MIHARA Y, KONDO R, et al. Antiproliferative effect of lenvatinib on human liver cancer cell lines in vitro and in vivo[J]. Anticancer Res, 2019, 39( 11): 5973- 5982. DOI: 10.21873/anticanres.13802.
    [4]
    KUDO M, UESHIMA K, IKEDA M, et al. Final results of TACTICS: A randomized, prospective trial comparing transarterial chemoembolization plus sorafenib to transarterial chemoembolization alone in patients with unresectable hepatocellular carcinoma[J]. Liver Cancer, 2022, 11( 4): 354- 367. DOI: 10.1159/000522547.
    [5]
    YANG C, ZHANG H, ZHANG L, et al. Evolving therapeutic landscape of advanced hepatocellular carcinoma[J]. Nat Rev Gastroenterol Hepatol, 2023, 20( 4): 203- 222. DOI: 10.1038/s41575-022-00704-9.
    [6]
    ZHONG BY, JIN ZC, CHEN JJ, et al. Role of transarterial chemoembolization in the treatment of hepatocellular carcinoma[J]. J Clin Transl Hepatol, 2023, 11( 2): 480- 489. DOI: 10.14218/JCTH.2022.00293.
    [7]
    General Office of National Health Commission. Standard for diagnosis and treatment of primary liver cancer(2022 edition)[J]. J Clin Hepatol, 2022, 38( 2): 288- 303. DOI: 10.3969/j.issn.1001-5256.2022.02.009.

    国家卫生健康委办公厅. 原发性肝癌诊疗指南(2022年版)[J]. 临床肝胆病杂志, 2022, 38( 2): 288- 303. DOI: 10.3969/j.issn.1001-5256.2022.02.009.
    [8]
    HUANG JT, ZHONG BY, JIANG N, et al. Transarterial chemoembolization combined with immune checkpoint inhibitors plus tyrosine kinase inhibitors versus immune checkpoint inhibitors plus tyrosine kinase inhibitors for advanced hepatocellular carcinoma[J]. J Hepatocell Carcinoma, 2022, 9: 1217- 1228. DOI: 10.2147/JHC.S386672.
    [9]
    Bureau of Medical Administration, National Health Commission of the People’s Republic of China. Guidelines for diagnosis and treatment of primary liver cancer in China(2019 edition)[J]. J Clin Hepatol, 2020, 36( 2): 277- 292. DOI: 10.3969/j.issn.1001-5256.2020.02.007.

    中华人民共和国国家卫生健康委员会医政医管局, 原发性肝癌诊疗规范(2019年版)[J]. 临床肝胆病杂志, 2020, 36( 2): 277- 292. DOI: 10.3969/j.issn.1001-5256.2020.02.007.
    [10]
    BASCH E, REEVE BB, MITCHELL SA, et al. Development of the National Cancer Institute’s patient-reported outcomes version of the common terminology criteria for adverse events(PRO-CTCAE)[J]. J Natl Cancer Inst, 2014, 106( 9): dju244. DOI: 10.1093/jnci/dju244.
    [11]
    LENCIONI R, LLOVET JM. Modified RECIST(mRECIST) assessment for hepatocellular carcinoma[J]. Semin Liver Dis, 2010, 30( 1): 52- 60. DOI: 10.1055/s-0030-1247132.
    [12]
    ZHU HD, LI HL, HUANG MS, et al. Transarterial chemoembolization with PD-(L)1 inhibitors plus molecular targeted therapies for hepatocellular carcinoma(CHANCE001)[J]. Signal Transduct Target Ther, 2023, 8( 1): 58. DOI: 10.1038/s41392-022-01235-0.
    [13]
    CHENG AL, QIN S, IKEDA M, et al. Updated efficacy and safety data from IMbrave150: Atezolizumab plus bevacizumab vs. sorafenib for unresectable hepatocellular carcinoma[J]. J Hepatol, 2022, 76( 4): 862- 873. DOI: 10.1016/j.jhep.2021.11.030.
    [14]
    REN Z, XU J, BAI Y, et al. Sintilimab plus a bevacizumab biosimilar(IBI305) versus sorafenib in unresectable hepatocellular carcinoma(ORIENT-32): a randomised, open-label, phase 2-3 study[J]. Lancet Oncol, 2021, 22( 7): 977- 990. DOI: 10.1016/S1470-2045(21)00252-7.
    [15]
    FINN RS, IKEDA M, ZHU AX, et al. Phase Ib study of lenvatinib plus pembrolizumab in patients with unresectable hepatocellular carcinoma[J]. J Clin Oncol, 2020, 38( 26): 2960- 2970. DOI: 10.1200/JCO.20.00808.
    [16]
    SCHICHO A, HELLERBRAND C, KRUGER K, et al. Impact of different embolic agents for transarterial chemoembolization(TACE) procedures on systemic vascular endothelial growth factor(VEGF) levels[J]. J Clin Transl Hepatol, 2016, 4( 4): 288- 292. DOI: 10.14218/JCTH.2016.00058.
    [17]
    SERGIO A, CRISTOFORI C, CARDIN R, et al. Transcatheter arterial chemoembolization(TACE) in hepatocellular carcinoma(HCC): the role of angiogenesis and invasiveness[J]. Am J Gastroenterol, 2008, 103( 4): 914- 921. DOI: 10.1111/j.1572-0241.2007.01712.x
    [18]
    GRETEN TF, MAUDA-HAVAKUK M, HEINRICH B, et al. Combined locoregional-immunotherapy for liver cancer[J]. J Hepatol, 2019, 70( 5): 999- 1007. DOI: 10.1016/j.jhep.2019.01.027
    [19]
    PALMER DH, MALAGARI K, KULIK LM. Role of locoregional therapies in the wake of systemic therapy[J]. J Hepatol, 2020, 72( 2): 277- 287. DOI: 10.1016/j.jhep.2019.09.023
    [20]
    SANGRO B, CHAN SL, MEYER T, et al. Diagnosis and management of toxicities of immune checkpoint inhibitors in hepatocellular carcinoma[J]. J Hepatol, 2020, 72( 2): 320- 341. DOI: 10.1016/j.jhep.2019.10.021
    [21]
    LLOVET JM, CASTET F, HEIKENWALDER M, et al. Immunotherapies for hepatocellular carcinoma[J]. Nat Rev Clin Oncol, 2022, 19( 3): 151- 172. DOI: 10.1038/s41571-021-00573-2.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(1)  / Tables(3)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (383) PDF downloads(61) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return