[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.
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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()

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《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.

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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