Transarterial chemoembolization with PD-(L)1 inhibitors plus molecular targeted therapies for hepatocellular carcinoma(CHANCE001)  

作　　者：Hai-Dong Zhu Hai-Liang Li Ming-Sheng Huang Wei-Zhu Yang Guo-Wen Yin Bin-Yan Zhong Jun-Hui Sun Zhi-Cheng Jin Jian-Jian Chen Nai-Jian Ge Wen-Bin Ding Wen-Hui Li Jin-Hua Huang Wei Mu Shan-Zhi Gu Jia-Ping Li Hui Zhao Shu-Wei Wen Yan-Ming Lei Yu-Sheng Song Chun-Wang Yuan Wei-Dong Wang Ming Huang Wei Zhao Jian-Bing Wu Song Wang Xu Zhu Jian-Jun Han Wei-Xin Ren Zai-Ming Lu Wen-Ge Xing Yong Fan Hai-Lan Lin Zi-Shu Zhang Guo-Hui Xu Wen-Hao Hu Qiang Tu Hong-Ying Su Chuan-Sheng Zheng Yong Chen Xu-Ya Zhao Zhu-Ting Fang Qi Wang Jin-Wei Zhao Ai-Bing Xu Jian Xu Qing-Hua Wu Huan-Zhang Niu Jian Wang Feng Dai Dui-Ping Feng Qing-Dong Li Rong-Shu Shi Jia-Rui Li Guang Yang Hai-Bin Shi Jian-Song Ji Yu-E Liu Zheng Cai Po Yang Yang Zhao Xiao-Li Zhu Li-Gong Lu Gao-Jun Teng 

机构地区：[1]Center of Interventional Radiology&Vascular Surgery,Department of Radiology,Zhongda Hospital,Medical School,Southeast University,Nanjing 210009,China [2]Department of Minimally invasive Intervention,The Affiliated Cancer Hospital of Zhengzhou University,Zhengzhou 450008,China [3]Department of Interventional Radiology,the Third Affiliated Hospital,Sun Yat-Sen University,Guangzhou 510630,China [4]Department of Interventional Radiology,Union Hospital of Fujian Medical University,Fuzhou 350001,China [5]Department of Interventional Radiology,Jiangsu Cancer Hospital&Jiangsu Institute of Cancer Research&The Affiliated Cancer Hospital of Nanjing Medical University,Nanjing 210009,China [6]Department of Interventional Radiology,The First Affiliated Hospital of Soochow University,Soochow University,Suzhou 215006,China [7]Hepatobiliary and Pancreatic Interventional Treatment Center,Division of Hepatobiliary and Pancreatic Surgery,The First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China [8]Department of Interventional Radiology,Eastern Hospital of Hepatobiliary Surgery,Navy Medical University(Second Military Medical University),Shanghai 200438,China [9]Department of Interventional Radiology,Nantong First People’s Hospital,Nantong 226001,China [10]Department of Interventional Radiology,Yancheng Third People’s Hospital,Yancheng 224008,China [11]Department of Minimally Invasive Interventional Therapy,Sun YatSen University Cancer Center,Guangzhou 510060,China [12]Department of Vascular Surgery,Southwest Hospital,Third Military Medical University(Army Medical University),Chongqing 400038,China. [13]Department of Interventional Radiology,Hunan Cancer Hospital,Changsha 410031,China [14]Department of Interventional Oncology,The First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China [15]Department of Interventional Radiology,The Hospital of Nantong University,Nantong 226001,China [16]Department of Interventional Therapy,Shanxi Tumor Hospital,Taiyuan 030001,China [17]Departme

出　　处：《Signal Transduction and Targeted Therapy》2023年第3期1198-1207,共10页信号转导与靶向治疗（英文）

基　　金：The study was supported by National Key Research and Development Program(2018YFA0704100,2018YFA0704104);National Natural Science Foundation of China(81827805,82130060);Jiangsu Provincial Special Program of Medical Science(BE2019750).The funding sources had no role in the writing of the report,or decision to submit the paper for publication.

摘　　要：There is considerable potential for integrating transarterial chemoembolization(TACE),programmed death-(ligand)1(PD-[L]1)inhibitors,and molecular targeted treatments(MTT)in hepatocellular carcinoma(HCC).It is necessary to investigate the therapeutic efficacy and safety of TACE combined with PD-(L)1 inhibitors and MTT in real-world situations.In this nationwide,retrospective,cohort study,826 HCC patients receiving either TACE plus PD-(L)1 blockades and MTT(combination group,n=376)or TACE monotherapy(monotherapy group,n=450)were included from January 2018 to May 2021.The primary endpoint was progression-free survival(PFS)according to modified RECIST.The secondary outcomes included overall survival(OS),objective response rate(ORR),and safety.We performed propensity score matching approaches to reduce bias between two groups.After matching,228 pairs were included with a predominantly advanced disease population.Median PFS in combination group was 9.5 months(95%confidence interval[CI],8.4-11.0)versus 8.0 months(95%CI,6.6-9.5)(adjusted hazard ratio[HR],0.70,P=0.002).OS and ORR were also significantly higher in combination group(median OS,19.2[16.1-27.3]vs.15.7 months[13.0-20.2];adjusted HR,0.63,P=0.001;ORR,60.1%vs.32.0%;P<0.001).Grade 3/4 adverse events were observed at a rate of 15.8%and 7.5%in combination and monotherapy groups,respectively.Our results suggest that TACE plus PD-(L)1 blockades and MTT could significantly improve PFS,OS,and ORR versus TACE monotherapy for Chinese patients with predominantly advanced HCC in real-world practice,with an acceptable safety profile.

关 键 词：HEPATOCELLULAR TARGETED MATCHING 

分 类 号：R735.7[医药卫生—肿瘤]