Hepatology International:仑伐替尼+TACE对比TACE在不可切除肝癌中的疗效:一项回顾性对照研究

2021-05-10 yd2015 MedSci原创

仑伐替尼+TACE较TACE显著改善不可切除肝癌的临床预后。

肝癌是我国常见的恶性肿瘤。虽然手术是其治愈的手段。但是大部分患者发现时已是不可切除。仑伐替尼目前已被批准用于晚期肝癌一线治疗。经皮动脉化疗栓塞(TACE)在临床上也广泛用于不可切除肝细胞癌(uHCC)患者的治疗中。但是目前没有研究评估两者联合治疗的效果。

近期,来自上海东方肝胆外科医院的曲增强教授团队,在Hepatology International杂志上发表了一项数据,该研究回顾性分析评估仑伐替尼+TACE对比TACE单独使用在不可切除肝癌中的疗效和安全性。该研究为单中心、回顾性对照研究,主要评估总生存(OS),无进展生存(PFS),客观缓解率(ORR)以及安全性。研究共纳入2017~2019年东方肝胆外科医院治疗的120例不可切除HCC患者,其中仑伐替尼+TACE和TACE组各有60例患者。

研究数据显示,总生存方面,仑伐替尼+TACE组的1年和2年OS率分别为88.4%和79.8%,而TACE单独组则为79.2%和49.2%,HR=0.466 (95%CI: 0.226~0.886, P=0.047)。因此,仑伐替尼+TACE组联合治疗显著延长了患者中位OS。对于无病进展生存方面,仑伐替尼+TACE组的1年和2年PFS率分别为78.4%和45.5%,而TACE单独组则为64.7%和38.0%,HR=0.343(95%CI: 0.198~0.595,p<0.001)。同样联合治疗显著延长了患者PFS。

                             两组疗效概况

                        两组OS和PFS

仑伐替尼+TACE组的ORR为 68.3%,而TACE单独组的ORR则为31.7%,有显著统计学意义(P<0.001);两组疾病控制率(DCR)分别为93.3%和86.7%,联合治疗组的DCR数值上也相对更高。

                       两组的ORR和DCR

从安全性来看,联合治疗组最常见的不良事件为白蛋白减少(55.0% vs. 38.3%)、高血压(48.3% vs. 0)和血小板减少(46.7% vs. 50.0%),最常见的3~4级不良事件为高血压(23.3%),总体上可耐受,可控。

                   不良事件

综上,仑伐替尼+TACE较TACE单独治疗显著改善不可切除肝癌的临床预后。

原始出处:

Zhigang Fu, Xiaowei Li, Jiaming Zhong, et al. Lenvatinib in combination with transarterial chemoembolization for treatment of unresectable hepatocellular carcinoma (uHCC): a retrospective controlled study. Hepatol Int. 2021 Apr 20.  doi: 10.1007/s12072-021-10184-9.  Online ahead of print.

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    2021-07-13 grace5700
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    2022-04-01 amyloid
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    2022-04-13 shanyongle
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encryptionId=db6969548d, topicName=eRNA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ad9f79, createdName=般若傻瓜, createdTime=Thu Sep 16 12:26:29 CST 2021, time=2021-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1885139, encodeId=7f8618851392d, content=<a href='/topic/show?id=3b2112532d8' target=_blank style='color:#2F92EE;'>#Nat#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12532, encryptionId=3b2112532d8, topicName=Nat)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e6f107, createdName=liye789132251, createdTime=Fri Sep 03 18:26:29 CST 2021, time=2021-09-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1427514, encodeId=d8b6142e51441, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Wed May 12 13:26:29 CST 2021, time=2021-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032909, encodeId=cca6103290950, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Tue May 11 01:26:29 CST 2021, time=2021-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1040383, encodeId=f5e3104038354, content=肝癌,接下来就要细分了,对于体质好的病人,能否将PD-1类+抗血管新生+放疗等相结合,甚至有必要用TACE进行减负, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=留走人康, createdTime=Tue May 11 01:26:29 CST 2021, time=2021-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=964434, encodeId=32a596443425, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=39cb5476878, createdName=ms3000001821055913, createdTime=Mon May 10 23:15:08 CST 2021, time=2021-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=964433, encodeId=b96f96443336, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=39cb5476878, createdName=ms3000001821055913, createdTime=Mon May 10 23:12:41 CST 2021, time=2021-05-10, status=1, ipAttribution=)]
    2021-09-16 般若傻瓜
  5. [GetPortalCommentsPageByObjectIdResponse(id=2033738, encodeId=e2422033e3817, content=<a href='/topic/show?id=fc431e0708f' target=_blank style='color:#2F92EE;'>#TAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17070, encryptionId=fc431e0708f, topicName=TAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b05b180, createdName=grace5700, createdTime=Tue Jul 13 16:26:29 CST 2021, time=2021-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1775562, encodeId=4cc41e75562ee, content=<a href='/topic/show?id=937d46650bf' target=_blank style='color:#2F92EE;'>#对照#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46650, encryptionId=937d46650bf, topicName=对照)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8ae138776909, 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encryptionId=db6969548d, topicName=eRNA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ad9f79, createdName=般若傻瓜, createdTime=Thu Sep 16 12:26:29 CST 2021, time=2021-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1885139, encodeId=7f8618851392d, content=<a href='/topic/show?id=3b2112532d8' target=_blank style='color:#2F92EE;'>#Nat#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12532, encryptionId=3b2112532d8, topicName=Nat)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e6f107, createdName=liye789132251, createdTime=Fri Sep 03 18:26:29 CST 2021, time=2021-09-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1427514, encodeId=d8b6142e51441, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Wed May 12 13:26:29 CST 2021, time=2021-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032909, encodeId=cca6103290950, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Tue May 11 01:26:29 CST 2021, time=2021-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1040383, encodeId=f5e3104038354, content=肝癌,接下来就要细分了,对于体质好的病人,能否将PD-1类+抗血管新生+放疗等相结合,甚至有必要用TACE进行减负, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=留走人康, createdTime=Tue May 11 01:26:29 CST 2021, time=2021-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=964434, encodeId=32a596443425, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=39cb5476878, createdName=ms3000001821055913, createdTime=Mon May 10 23:15:08 CST 2021, time=2021-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=964433, encodeId=b96f96443336, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=39cb5476878, createdName=ms3000001821055913, createdTime=Mon May 10 23:12:41 CST 2021, time=2021-05-10, status=1, ipAttribution=)]
    2021-09-03 liye789132251
  6. [GetPortalCommentsPageByObjectIdResponse(id=2033738, encodeId=e2422033e3817, content=<a href='/topic/show?id=fc431e0708f' target=_blank style='color:#2F92EE;'>#TAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17070, encryptionId=fc431e0708f, topicName=TAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b05b180, createdName=grace5700, createdTime=Tue Jul 13 16:26:29 CST 2021, time=2021-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1775562, encodeId=4cc41e75562ee, content=<a href='/topic/show?id=937d46650bf' target=_blank style='color:#2F92EE;'>#对照#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46650, encryptionId=937d46650bf, topicName=对照)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8ae138776909, 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encryptionId=db6969548d, topicName=eRNA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ad9f79, createdName=般若傻瓜, createdTime=Thu Sep 16 12:26:29 CST 2021, time=2021-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1885139, encodeId=7f8618851392d, content=<a href='/topic/show?id=3b2112532d8' target=_blank style='color:#2F92EE;'>#Nat#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12532, encryptionId=3b2112532d8, topicName=Nat)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e6f107, createdName=liye789132251, createdTime=Fri Sep 03 18:26:29 CST 2021, time=2021-09-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1427514, encodeId=d8b6142e51441, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Wed May 12 13:26:29 CST 2021, time=2021-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032909, encodeId=cca6103290950, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Tue May 11 01:26:29 CST 2021, time=2021-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1040383, encodeId=f5e3104038354, content=肝癌,接下来就要细分了,对于体质好的病人,能否将PD-1类+抗血管新生+放疗等相结合,甚至有必要用TACE进行减负, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=留走人康, createdTime=Tue May 11 01:26:29 CST 2021, time=2021-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=964434, encodeId=32a596443425, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=39cb5476878, createdName=ms3000001821055913, createdTime=Mon May 10 23:15:08 CST 2021, time=2021-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=964433, encodeId=b96f96443336, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=39cb5476878, createdName=ms3000001821055913, createdTime=Mon May 10 23:12:41 CST 2021, time=2021-05-10, status=1, ipAttribution=)]
    2021-05-12 gwc384
  7. [GetPortalCommentsPageByObjectIdResponse(id=2033738, encodeId=e2422033e3817, content=<a href='/topic/show?id=fc431e0708f' target=_blank style='color:#2F92EE;'>#TAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17070, encryptionId=fc431e0708f, topicName=TAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b05b180, createdName=grace5700, createdTime=Tue Jul 13 16:26:29 CST 2021, time=2021-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1775562, encodeId=4cc41e75562ee, content=<a href='/topic/show?id=937d46650bf' target=_blank style='color:#2F92EE;'>#对照#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46650, encryptionId=937d46650bf, topicName=对照)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8ae138776909, 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level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Wed May 12 13:26:29 CST 2021, time=2021-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032909, encodeId=cca6103290950, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Tue May 11 01:26:29 CST 2021, time=2021-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1040383, encodeId=f5e3104038354, content=肝癌,接下来就要细分了,对于体质好的病人,能否将PD-1类+抗血管新生+放疗等相结合,甚至有必要用TACE进行减负, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=留走人康, createdTime=Tue May 11 01:26:29 CST 2021, time=2021-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=964434, encodeId=32a596443425, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=39cb5476878, createdName=ms3000001821055913, createdTime=Mon May 10 23:15:08 CST 2021, time=2021-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=964433, encodeId=b96f96443336, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=39cb5476878, createdName=ms3000001821055913, createdTime=Mon May 10 23:12:41 CST 2021, time=2021-05-10, status=1, ipAttribution=)]
    2021-05-11 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

  8. 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encryptionId=db6969548d, topicName=eRNA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ad9f79, createdName=般若傻瓜, createdTime=Thu Sep 16 12:26:29 CST 2021, time=2021-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1885139, encodeId=7f8618851392d, content=<a href='/topic/show?id=3b2112532d8' target=_blank style='color:#2F92EE;'>#Nat#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12532, encryptionId=3b2112532d8, topicName=Nat)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e6f107, createdName=liye789132251, createdTime=Fri Sep 03 18:26:29 CST 2021, time=2021-09-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1427514, encodeId=d8b6142e51441, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=留走人康, createdTime=Tue May 11 01:26:29 CST 2021, time=2021-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=964434, encodeId=32a596443425, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=39cb5476878, createdName=ms3000001821055913, createdTime=Mon May 10 23:15:08 CST 2021, time=2021-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=964433, encodeId=b96f96443336, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=39cb5476878, createdName=ms3000001821055913, createdTime=Mon May 10 23:12:41 CST 2021, time=2021-05-10, status=1, ipAttribution=)]
    2021-05-11 留走人康

    肝癌,接下来就要细分了,对于体质好的病人,能否将PD-1类+抗血管新生+放疗等相结合,甚至有必要用TACE进行减负

    0

  9. 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level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Wed May 12 13:26:29 CST 2021, time=2021-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032909, encodeId=cca6103290950, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Tue May 11 01:26:29 CST 2021, time=2021-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1040383, encodeId=f5e3104038354, content=肝癌,接下来就要细分了,对于体质好的病人,能否将PD-1类+抗血管新生+放疗等相结合,甚至有必要用TACE进行减负, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, 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createdTime=Mon May 10 23:12:41 CST 2021, time=2021-05-10, status=1, ipAttribution=)]
    2021-05-10 ms3000001821055913

    0

  10. 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createdTime=Mon May 10 23:12:41 CST 2021, time=2021-05-10, status=1, ipAttribution=)]
    2021-05-10 ms3000001821055913

    0

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