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

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

DOI: 10.12449/JCH241017
  • 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)

More Information
  • 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
  •   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.

     

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