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ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 38 Issue 5
May  2022
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Article Navigation >  Journal of Clinical Hepatology  > 2022  >  38(5): 1086-1091

Efficacy and safety of programmed death-1 inhibitor combined with transarterial chemoembolization and anti-angiogenic drugs in treatment of advanced hepatocellular carcinoma

DOI: 10.3969/j.issn.1001-5256.2022.05.021

  • Department of Gastroenterology, The First Affiliated Hospital of Air Force Medical University, Xi'an 710032, China

Research funding:

National Natural Science Foundation of China(Geraral Program) (81870421)

More Information
  • Corresponding author: ZHOU Xinmin, zhouxmm@fmmu.edu.cn(ORCID: 0000-0002-6521-9885)
  • Received Date: 2021-09-13
  • Accepted Date: 2021-10-20
  • Published Date: 2022-05-20
    Abstract
  •   Objective  To investigate the efficacy and safety of programmed death receptor-1 (PD-1) inhibitor combined with transarterial chemoembolization (TACE) and anti-angiogenic drug tyrosine kinase inhibitor (TKI) versus TACE combined with TKI in the treatment of advanced hepatocellular carcinoma (HCC) and related influencing factors for prognosis.  Methods  An analysis was performed for all patients who received TACE+TKI+PD-1 inhibitor and some patients who received TACE+TKI in The First Affiliated Hospital of Air Force Medical University from June 2018 to July 2021. Related clinical data were collected, and propensity score matching (PSM) was used to balance the baseline characteristics between groups. The chi-square test was used for comparison of categorical data between two groups; the Wilcoxon rank-sum test was used for comparison of the number of TACE procedures between two groups; the Kaplan-Meier method was used to analyze overall survival (OS), and univariate and multivariate Cox regression models were used to analyze the influencing factors for prognosis.  Results  A total of 181 patients with advanced HCC were screened out, among whom 50 patients were treated with TACE+TKI+PD-1 inhibitor; after PSM, 40 patients treated with TACE+TKI+PD-1 inhibitor were enrolled as observation group and 40 patients treated with TACE+TKI were enrolled as control group. At the end of follow-up, the median follow-up time was 28.6 (95% confidence interval [CI]: 22.1-35.1) months, and the median OS was 15.9 (95%CI: 7.5-24.2) months in the observation group and 11.2 (95%CI: 5.0-17.5) months in the control group. The Cox regression analysis showed that the application of PD-1 inhibitor (hazard ratio [HR]=0.42, 95%CI: 0.23-0.80, P=0.008), the number of TACE procedures (HR=0.67, 95%CI: 0.46-0.99, P=0.043), Child-Pugh class (HR=2.40, 95%CI: 1.15-5.00, P=0.019), and vascular invasion (HR=3.42, 95%CI: 1.11-9.42, P=0.031) were independent influencing factors for prognosis. The incidence rate of grade > 2 adverse events was 40% for both the observation group and the control group, and there was no significant difference between the two groups (P=0.818).  Conclusion  Compared with TACE+TKI, TACE+TKI+PD-1 inhibitor can significantly prolong the OS of patients in advanced HCC, with relatively controllable adverse events.

     

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