[1]宋 震,李园园,王文刚,等.TACE联合酪氨酸激酶抑制剂和卡瑞利珠单抗对中晚期肝癌的疗效与安全性[J].介入放射学杂志,2023,32(06):549-553.
　SONG Zhen,LI Yuanyuan,WANG Wengang,et al.Efficacy and safety of TACE combined with TKIs plus camrelizumab for the treatment of intermediate and advanced hepatocellular carcinoma[J].journal interventional radiology,2023,32(06):549-553.
点击复制

TACE联合酪氨酸激酶抑制剂和卡瑞利珠单抗对中晚期肝癌的疗效与安全性()

PDF下载中关闭

分享到：

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
32
期数:
2023年06
页码:
549-553
栏目:
肿瘤介入
出版日期:
2023-06-28

文章信息/Info

Title:
Efficacy and safety of TACE combined with TKIs plus camrelizumab for the treatment of intermediate and advanced hepatocellular carcinoma
作者:
宋 震;  李园园;  王文刚;  殷雪瑞;  肖晋昌;  顾玉明
Author(s):
SONG Zhen;  LI Yuanyuan;  WANG Wengang;  YIN Xuerui;  XIAO Jinchang;  GU Yuming.
The Affiliated Hospital of Xuzhou Medical University， Xuzhou， Jiangsu Province 221006， China
关键词:
【关键词】 肝细胞癌;  卡瑞利珠单抗;  酪氨酸激酶抑制剂;  经动脉化疗栓塞术
文献标志码:
A
摘要:
【摘要】 目的 比较经动脉化疗栓塞术（transarterial chemoembolization，TACE）联合酪氨酸激酶抑制剂（tyrosine kinase inhibitors，TKI）和卡瑞利珠单抗与TKI联合卡瑞利珠单抗对中晚期肝细胞癌（hepatocellular carcinoma，HCC）的疗效与安全性。方法 选择2019年7月至2021年10月徐州医科大学附属医院诊治的中晚期HCC患者52例，其中TACE联合TKI和卡瑞利珠单抗治疗患者31例（实验组），TKI联合卡瑞利珠单抗治疗患者21例（对照组）。治疗后1、3、6、12个月复查上腹部增强MR，采用mRECIST标准评价短期疗效，比较两组无进展生存期（progression-free survival，PFS）、疾病控制率（disease control rate，DCR）和不良事件发生率。结果 实验组mPFS为10.5个月，对照组为7.3个月，差异有统计学意义（P=0.038）。实验组DCR为 87.1% ，对照组为61.9%，差异有统计学意义（P=0.03）。实验组TACE术后栓塞综合征发生率为100%（31/31），其中发热及疼痛发生率显著高于对照组，为64.5% 比0（P＜0.01）、35.5%比0（P=0.002），两组药物相关不良反应发生率差异无统计学意义（93.5%比85.7%，P=0.645）。结论 TACE联合TKI和卡瑞利珠单抗治疗中晚期HCC的mPFS和DCR优于TKI联合卡瑞利珠单抗，不良反应发生率较高。

参考文献/References:

［1］ Lencioni R， De Baere T， Soulen MC， et al. Lipiodol transarterial chemoembolization for hepatocellular carcinoma： a systematic review of efficacy and safety data［J］. Hepatology， 2016， 64： 106- 116.
［2］ Llovet JM， Ricci S， Mazzaferro V， et al. Sorafenib in advanced hepatocellular carcinoma［J］. N Engl J Med， 2008， 359： 378- 390.
［3］ Voutsadakis IA. PD- 1 inhibitors monotherapy in hepatocellular carcinoma：meta- analysis and systematic review［J］. Hepatobiliary Pancreat Dis Int， 2019， 18： 505- 510.
［4］ Finn RS，Qin S，Ikeda M，et al. Atezolizumab plus bevacizumab in unresectable hepatocellular carcinoma［J］. N Engl J Med， 2020， 382： 1894- 1905.
［5］ Montasser A，Beaufrere A，Cauchy F，et al. Transarterial chemo- embolisation enhances programmed death- 1 and programmed death- ligand 1 expression in hepatocellular carcinoma［J］. Histopathology， 2021， 79： 36- 46.
［6］ Lencioni R. Chemoembolization for hepatocellular carcinoma［J］. Semin Oncol， 2012， 39： 503- 509.
［7］ 安天志，高 嵩，靳 勇，等． 中国肝细胞癌经动脉化疗栓塞治疗（TACE）临床实践指南［J］． 介入放射学杂志， 2018， 27：1117- 1126．
［8］ Llovet JM， Lencioni R. mRECIST for HCC： performance and novel refinements［J］. J Hepatol， 2020， 72： 288- 306.
［9］ 李虎子，贾英杰，孔凡铭，等． 改良RECIST标准更适用经TACE治疗的肝癌患者的预后评价［J］． 介入放射学杂志， 2016， 25：29- 33．
［10］ Liu S，Liu KC，Lv WF，et al. The efficacy and prognostic factors of the combination of TACE and apatinib for the treatment of BCLC stage C hepatocellular carcinoma［J］. Front Med （Lausanne）， 2021， 8： 774345.
［11］ Peng S，Zhang YY，Peng H，et al. Intracellular autocrine VEGF signaling promotes EBDC cell proliferation， which can be inhibited by apatinib［J］. Cancer Lett， 2016， 373： 193- 202.
［12］ Peng S，Wang Y，Peng H，et al. Autocrine vascular endothelial growth factor signaling promotes cell proliferation and modulates sorafenib treatment efficacy in hepatocellular carcinoma［J］. Hepatology， 2014， 60： 1264- 1277.
［13］ Fukumura D，Kloepper J，Amoozgar Z，et al. Enhancing cancer immunotherapy using antiangiogenics： opportunities and challenges［J］. Nat Rev Clin Oncol， 2018， 15： 325- 340.
［14］ Qin S，Ren Z，Meng Z，et al. Camrelizumab in patients with previously treated advanced hepatocellular carcinoma： a multicentre， open- label， parallel- group， randomised， phase 2 trial［J］. Lancet Oncol， 2020， 21： 571- 580.
［15］ Qin S，Li Q，Gu S，et al. Apatinib as second-line or later therapy in patients with advanced hepatocellular carcinoma（AHELP）： a multicentre， double- blind， randomised， placebo- controlled， phase 3 trial［J］. Lancet Gastroenterol Hepatol， 2021， 6：559- 568.
［16］ Xu J，Shen J，Gu S，et al. Camrelizumab in combination with apatinib in patients with advanced hepatocellular carcinoma（RESCUE）： a nonrandomized， open- label， phase Ⅱ trial［J］. Clin Cancer Res， 2021， 27： 1003- 1011
［17］ Teng Y，Ding X，Li W，et al. A retrospective study on therapeutic efficacy of transarterial chemoembolization combined with immune checkpoint inhibitors plus lenvatinib in patients with unresec- table hepatocellular carcinoma［J］. Technol Cancer Res Treat， 2022， 21： 15330338221075174.
［18］ Dall’Olio FG，Marabelle A，Caramella C，et al. Tumour burden and efficacy of immune- checkpoint inhibitors［J］. Nat Rev Clin Oncol， 2022， 19： 75-90.
［19］ Llovet JM，De Baere T，Kulik L，et al. Locoregional therapies in the era of molecular and immune treatments for hepatocellular carcinoma［J］. Nat Rev Gastroenterol Hepatol， 2021， 18： 293- 313.
［20］ Jindal A，Thadi A，Shailubhai K. Hepatocellular carcinoma： etiology and current and future drugs［J］. J Clin Exp Hepatol， 2019， 9： 221- 232.
［21］ Lu W，Jin XL，Yang C，et al. Comparison of efficacy between TACE combined with apatinib and TACE alone in the treatment of intermediate and advanced hepatocellular carcinoma： a single- center randomized controlled trial［J］. Cancer Biol Ther， 2017， 18： 433- 438.
［22］ Missiaen R，Mazzone M，Bergers G. The reciprocal function and regulation of tumor vessels and immune cells offers new therapeutic opportunities in cancer［J］. Semin Cancer Biol， 2018， 52（Pt 2）： 107- 116.

相似文献/References:

[1]李晓峰,钱国军,张 磊,等. 微波高功率条件下消融原发性肝癌的初步研究[J].介入放射学杂志,2011,(12):974.
　LI Xiao-feng,QIAN Guo-jun,ZHANG Lei,et al.Microwave ablation with high output power for the treatment of hepatocellular carcinoma: a preliminary study[J].journal interventional radiology,2011,(06):974.
[2]姚雪松,李 槐.不可手术切除的肝细胞癌的疗效评价标准——改良ＲＥＣＩＳＴ标准更可靠[J].介入放射学杂志,2012,(03):177.
　. Ｔｈｅｒａｐｅｕｔｉｃ ｅｖａｌｕａｔｉｏｎ ｃｒｉｔｅｒｉｏｎ ｏｆ ｉｎｏｐｅｒａｂｌｅ ｈｅｐａｔｏｃｅｌｌｕｌａｒ ｃａｒｃｉｎｏｍａｓ： ｍｏｄｉｆｉｅｄ ＲＥＣＩＳＴ ａｓ ａ ｍｏｒｅ ｒｅｌｉａｂｌｅ ｓｔａｎｄａｒｄ[J].journal interventional radiology,2012,(06):177.
[3]孙 磊,施海彬,刘 圣,等.肝细胞癌肝动脉门静脉分流形成的相关因素分析[J].介入放射学杂志,2012,(03):206.
　,,et al.Ｔｈｅ ｆａｃｔｏｒｓ ｒｅｌａｔｅｄ ｔｏ ｔｈｅ ｆｏｒｍａｔｉｏｎ ｏｆ ａｒｔｅｒｉｏｐｏｒｔａｌ ｓｈｕｎｔｉｎｇ ｉｎ ｐａｔｉｅｎｔｓ ｗｉｔｈ ｈｅｐａｔｏｃｅｌｌｕｌａｒ ｃａｒｃｉｎｏｍａｓ [J].journal interventional radiology,2012,(06):206.
[4]梁茂全,苏洪英. 肝癌化疗栓塞前后甲胎蛋白变化模式的临床意义[J].介入放射学杂志,2012,(04):333.
　.Ｔｈｅ ｔｒａｎｓｆｏｒｍａｔｉｏｎ ｐａｔｔｅｒｎ ｏｆ ｓｅｒｕｍ аｆｅｔｏｐｒｏｔｅｉｎ ａｆｔｅｒ ｔｒａｎｓｃａｔｈｅｔｅｒ ａｒｔｅｒｉａｌ ｃｈｅｍｏｅｍｂｏｌｉｚａｔｉｏｎ ｉｎ ｐａｔｉｅｎｔｓ ｗｉｔｈ ｈｅｐａｔｏｃｅｌｌｕｌａｒ ｃａｒｃｉｎｏｍａ： ｉｔｓ ｃｌｉｎｉｃａｌ ｓｉｇｎｉｆｉｃａｎｃｅ [J].journal interventional radiology,2012,(06):333.
[5]沈海洋,刘瑞宝,刘 岩,等. 肝右叶前、后段原发性肝癌TACE后VEGF及CD34的表达水平 ；[J].介入放射学杂志,2012,(06):469.
　SHEN Hai- yang,LIU Rui- bao,LIU Yan,et al. The expression levels of vascular endothelial growth factor and CD34 in residual cancerous tissues of primary hepatocellular carcinoma located at anterior and posterior segments of right lobe liver after TACE[J].journal interventional radiology,2012,(06):469.
[6]彭辽河,胡晓燕,李 杰,等. 18F-FDG PET/CT显像在肝细胞癌TACE术后残留或复发病灶检出中的应用价值[J].介入放射学杂志,2012,(08):636.
　PENG Liao- he,HU Xiao- yan,LI Jie,et al. Clinical application of 18F- FDG PET/CT imaging in detecting residual lesions or recurrence foci of hepatocellular carcinoma after TACE treatment[J].journal interventional radiology,2012,(06):636.
[7]姚雪松,闫 东,曾辉英,等. TACE联合索拉非尼治疗不能手术切除肝细胞肝癌50例[J].介入放射学杂志,2013,(05):381.
　YAO Xue? song,YAN Dong,ZENG Hui? ying,et al. Ttransarterial chemoembolization combined with sorafenib for inoperable hepatocellular carcinoma： a clinical analysis of 50 cases[J].journal interventional radiology,2013,(06):381.
[8]陆小华,朱小庆,茅国新.肝细胞癌相关单核苷酸多态性的研究进展[J].介入放射学杂志,2013,(06):520.
　LU Xiao? hua,ZHU Xiao? qing,MAO Guo? xin.. Hepatocellular carcinoma?蛳 related single nucleotide polymorphisms： recent advances in research[J].journal interventional radiology,2013,(06):520.
[9]赵 松,陈学春,龙清云,等. 经肝动脉化疗栓塞联合射频消融治疗肝细胞癌疗效荟萃分析[J].介入放射学杂志,2013,(11):908.
　ZHAO Song,CHEN Xue? chun,LONG Qing? yun,et al. Transcatheter arterial chemoembolization combined with radiofrequency ablation for the treatment of hepatocellular carcinoma： a systematic review and Meta analysis[J].journal interventional radiology,2013,(06):908.
[10]易长虹,袁琳波,钱 坤,等.肝动脉灌注3-溴丙酮酸阻断大鼠肝癌能量代谢的实验研究[J].介入放射学杂志,2013,(12):1027.
　YI Chang? hong,YUAN Lin? bo,QIAN Kun,et al. Hepatic arterial infusion of 3?蛳 bromopyruvate to block up the energy metabolism of hepatic carcinoma： an experimental study in rats[J].journal interventional radiology,2013,(06):1027.
[11]黄 剑,葛乃建,徐 伟,等.TACE联合卡瑞利珠单抗及甲磺酸阿帕替尼治疗晚期肝细胞癌16例[J].介入放射学杂志,2021,30(08):774.
　HUANG Jian,GE Naijian,XU Wei,et al.TACE combined with camrelizumab and apatinib for advanced hepatocellular carcinoma： preliminary results in 16 patients[J].journal interventional radiology,2021,30(06):774.
[12]杨炜浩,仲斌演,杨 飞,等.经动脉化疗栓塞联合卡瑞利珠单抗及酪氨酸激酶抑制剂治疗中晚期肝细胞癌的安全性及近期疗效[J].介入放射学杂志,2022,31(05):459.
　YANG Weihao,ZHONG Binyan,YANG Fei,et al.Transarterial chemoembolization combined with camrelizumab and tyrosine kinase inhibitor for advanced hepatocellular carcinoma： its safety and short-term efficacy[J].journal interventional radiology,2022,31(06):459.
[13]苏 珂,徐尧阳,郭 露,等.肝动脉化疗栓塞联合卡瑞利珠单抗治疗中晚期肝细胞癌的疗效分析[J].介入放射学杂志,2022,31(09):865.
　SU Ke,XU Yaoyang,GUO Lu,et al.Hepatic arterial chemoembolization combined with camrelizumab for the treatment of mid-to-advanced hepatocellular carcinoma： analysis of its curative efficacy[J].journal interventional radiology,2022,31(06):865.

备注/Memo

备注/Memo:
（收稿日期：2022- 08- 20）
（本文编辑：新 宇）
更新日期/Last Update: 2023-06-26