Efficacy and safety of camrelizumab monoclonal antibody combined with molecular-targeted therapy in elderly patients with advanced hepatocellular carcinoma

Long CHENG; Yue ZHANG; Yushen LIU; Zhaoqing DU; Zhaoyang GUO; Yangwei FAN; Ting LI; Xu GAO; Enrui XIE; Zixuan XING; Wenhua WU; Yinying WU; Mingbo YANG; Jie LI; Yu ZHANG; Wen KANG; Wenjun WANG; Fanpu JI; Jiang GUO; Ning GAO

doi:10.12449/JCH241017

Volume 40 Issue 10

Oct. 2024

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Article Navigation > Journal of Clinical Hepatology > 2024 > 40(10): 2034-2041

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Efficacy and safety of camrelizumab monoclonal antibody combined with molecular-targeted therapy in elderly patients with advanced hepatocellular carcinoma

DOI: 10.12449/JCH241017

Long CHENG¹,
Yue ZHANG^{2a, 3},
Yushen LIU⁴,
Zhaoqing DU⁶,
Zhaoyang GUO⁷,
Yangwei FAN⁸,
Ting LI^{2a, 8},
Xu GAO^{2a, 2b},
Enrui XIE^2a,
Zixuan XING^2a,
Wenhua WU^2a,
Yinying WU⁷,
Mingbo YANG³,
Jie LI⁹,
Yu ZHANG⁵,
Wen KANG⁴,
Wenjun WANG^2a,
Fanpu JI^2a,
Jiang GUO^{1
,
,
,},
Ning GAO^{2a
,
,
,}

1.
Department of Oncology and Interventional Radiology，Beijing Ditan Hospital，Capital Medical University，Beijing 100015，China
2a.
Department of Infectious Diseases，The Second Affiliated Hospital of Xi’an Jiaotong University Xi’an 710004，China
2b.
Department of Gastroenterology，The Second Affiliated Hospital of Xi’an Jiaotong University，Xi’an 710004，China
3.
Fourth Department of Liver Diseases，Xi’an Eighth Hospital，Xi’an 710061，China
4.
Department of Infectious Diseases，The Second Affiliated Hospital of Air Force Medical University，Xi’an 710038，China
5.
Department of Hepatobiliary Surgery，Shaanxi Provincial People’s Hospital，Xi’an 710068，China
6.
Department of Infectious Diseases，Shandong Provincial Hospital，Jinan 250021，China
7.
Department of Medical Oncology，The First Affiliated Hospital of Xi’an Jiaotong University，Xi’an 710061，China
8.
Department of Hematology，Rheumatology and Immunology，The First People’s Hospital of Xianyang，Xianyang，Shaanxi 721000，China
9.
Department of Infectious Diseases，Nanjing Drum Tower Hospital，Nanjing 210008，China

Research funding:

National Natural Science Foundation of China (82170626);

Natural Science Foundation of Shaanxi Province (2022SF-451);

Capital Health Development Research Special Project (2024-2-2176)

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Corresponding author: GUO Jiang， guojiang7606@ccmu.edu.cn （ORCID： 0000-0001-8297-5458）; GAO Ning， gaohuining1@163.com （ORCID： 0000-0003-1018-3990）
Received Date: 2024-01-22
Accepted Date: 2024-04-29
Published Date: 2024-10-25

Abstract

Abstract

Objective To investigate the efficacy and safety of camrelizumab monoclonal antibody combined with molecular-targeted therapy in elderly patients with unresectable or advanced hepatocellular carcinoma （HCC）. Methods A retrospective analysis was performed for the patients with unresectable/advanced HCC who attended six hospitals from January 1， 2019 to March 31， 2021， and all patients received camrelizumab monoclonal antibody treatment， among whom 84.8% also received targeted therapy. According to the age of the patients， they were divided into elderly group （≥65 years） and non-elderly group （<65 years）. The two groups were assessed in terms of overall survival （OS）， progression-free survival （PFS）， objective response rate （ORR）， disease control rate （DCR）， and immune-related adverse events （irAE）. The chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups； the independent samples t-test was used for comparison of normally distributed continuous data， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups. The Kaplan-Meier method was used for survival analysis， and the log-rank test was used for comparison of survival curves. Univariate and multivariate Cox proportional hazards regression analyses were used to determine the independent influencing factors for PFS and DCR at 6 months. Results A total of 99 HCC patients were enrolled， with 27 in the elderly group and 72 in the non-elderly group. The elderly group had an OS rate of 67.8%， an ORR of 44.4%， and a DCR of 74.1% at 12 months and a median PFS of 6.4 （95% confidence interval ［CI］： 3.0‍ ‍—‍ ‍12.4） months， with no significant differences compared with the non-elderly group （all P>0.05）. The median OS was unavailable for the elderly group， while the non-elderly group had an OS of 18.9 （95%CI： 13.0‍ ‍—‍ ‍24.8） months； there was no significant difference between the two groups （P=0.485）. The univariate and multivariate Cox regression analyses showed that major vascular invasion （MVI） was an independent risk factor for PFS （hazard ratio ［HR］=2.603， 95%CI： 1.136‍ ‍—‍ ‍5.964， P=0.024） and DCR （HR=3.963， 95%CI： 1.671‍ ‍—‍ ‍9.397， P=0.002） at 6 months， while age， sex， etiology of HBV infection， presence of extrahepatic metastasis， Child-Pugh class B， and alpha-fetoprotein>400 ng/mL were not associated with PFS or DCR at 6 months. For the elderly group， the incidence rates of any irAE and grade 3/4 irAE were 51.9% and 25.9%， respectively， with no significant differences compared with the non-elderly group （P>0.05）， and skin disease was the most common irAE in both groups （39.4%）. Conclusion Camrelizumab monoclonal antibody combined with molecular-targeted therapy has similar efficacy and safety in patients with unresectable/advanced HCC aged ≥65 years and those aged <65 years. MVI is associated with suboptimal response to immunotherapy and poor prognosis.
- Carcinoma， Hepatocellular,
- Antibodies， Monoclonal， Humanized,
- Molecular Targeted Therapy,
- Aged

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References(23)

References

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Efficacy and safety of camrelizumab monoclonal antibody combined with molecular-targeted therapy in elderly patients with advanced hepatocellular carcinoma

DOI: 10.12449/JCH241017

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Efficacy and safety of camrelizumab monoclonal antibody combined with molecular-targeted therapy in elderly patients with advanced hepatocellular carcinoma

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