TACE联合瑞戈非尼及PD-1二线序贯治疗中晚期肝细胞癌的临床研究  

TACE combined with regorafenib and PD-1 second-line sequential therapy for advanced hepatocellular carcinoma:a clinical study

作　　者：石佳鹏 汤小星[1] 顾祝新[2] 施荣峰 陆小华[2] 赵辉[2] SHI Jiapeng;TANG Xiaoxing;GU Zhuxin;SHI Rongfeng;LU Xiaohua;ZHAO Hui(Interventional Department of Nantong Traditional Chinese Medicine Hospital,Nantong,Jiangsu Province 226001,China)

机构地区：[1]南通市中医院介入科,江苏南通226001 [2]南通大学附属医院介入与血管外科

出　　处：《介入放射学杂志》2024年第9期995-1000,共6页Journal of Interventional Radiology

摘　　要：目的 探讨TACE联合瑞戈非尼及程序性死亡受体(PD-1)二线序贯治疗中晚期肝细胞癌(HCC)的有效性和安全性。方法 纳入南通大学附属医院及南通市第三人民医院2020年10月至2022年5月所有接受TACE联合瑞戈非尼及PD-1(TACE-RP,三联组)和接受TACE联合瑞戈非尼治疗(TACE-R,二联组)的患者进行回顾性研究,共83例。收集、评估患者的临床资料,采用改良的实体瘤反应评估标准(mRECIST方法)评估治疗效果,比较两组患者无进展生存期(PFS)、总生存期(OS)以及治疗相关不良事件(TRAEs)。以Kaplan-Meier法绘制PFS及OS曲线,采用Log-rank检验进行组间比较,绘制COX回归模型确定PFS和OS的影响因素。结果 两组患者基线数据差异无统计学意义(P≥0.05);三联组患者客观缓解率(ORR,31.1%vs 18.4%,P=0.024)和疾病控制率(DCR,77.8%vs 57.8%,P=0.038)均高于二联组。三联组患者的mOS、mPFS均高于二联组(分别为16.80个月vs13.20个月,9.10个月vs 7.40个月)。两组间用药不良反应差异无统计学意义(P≥0.05)。结论 TACE联合瑞戈非尼及PD-1二线序贯治疗中晚期HCC较TACE联合瑞戈非尼治疗效果更佳,可优先作为HCC的二线治疗。Objective To discuss the effectiveness and safety of transarterial chemoembolization(TACE)combined with regorafenib and programmed death receptor-1(PD-1)in the second-line sequential treatment of advanced hepatocellular carcinoma(HCC).Methods The clinical data of a total of 83 patients with advanced HCC,who received TACE combined with regorafenib and PD-1(triple-therapy group)or TACE combined with regorafenib(dual-therapy group)at the Affiliated Hospital of Nantong University and Nantong Municipal Third People′s Hospital of China between October 2020 and May 2022,were retrospectively analyzed.The clinical data were collected and evaluated.Modified response evaluation criteria in solid tumors(mRECIST)was used to evaluate the curative effect.The progression-free survival(PFS),overall survival(OS)and treatment-related adverse events(TRAEs)were compared between the two groups.The Kaplan-Meier method was used to draw PFS and OS curves,the Log-rank test was used to compare the relevant data between the two groups,and the COX regression model was drawn to determine the factors influencing PFS and OS.Results There were no statistically significant differences in the baseline data between the two groups(P≥0.05).In the triple-therapy group and the dual-therapy group,the objective response rate(ORR)was 31.1%and 18.4%respectively(P=0.024),and the disease control rate(DCR)was 77.8%and 57.8%respectively(P=0.038).The OS and PFS in the triple-therapy group were higher than those in the dual-therapy group(16.80 months vs 13.20 months,and 9.10 months vs.7.40 months,respectively).No statistically significant difference in the incidence of adverse drug reactions existed between the two groups(P≥0.05).Conclusion In the second-line sequential treatment of advanced HCC,TACE combined with regorafenib and PD-1 is more effective than TACE combined with regorafenib,therefore,it can be used as a preferred second-line treatment for advanced HCC.

关 键 词：肝细胞癌 TACE 瑞戈非尼 PD-1 临床疗效 安全性 

分 类 号：R735.7[医药卫生—肿瘤]