Toripalimab in combination with Anlotinib for unresectable hepatocellular carcinoma after SBRT: A prospective, single-arm, single-center clinical study

ObjectiveExposing tumor antigens to the immune system is the key to ensuring the efficacy of immunotherapy. SBRT is the main way to reveal the specifical antigens of tumors which can enhance the immune response. We aimed to explore the clinical efficacy and safety of Toripalimab combined with Anloti...

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Main Authors: Yongbiao Chen, Hanyin Hong, Wenzheng Fang, Xia Zhang, Huachun Luo, Zhijian Chen, Jianda Yu, Weiqiang Fan, Xiaobin Chi, Yonghai Peng
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-03-01
Series:Frontiers in Oncology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2023.1113389/full
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author Yongbiao Chen
Hanyin Hong
Wenzheng Fang
Xia Zhang
Huachun Luo
Zhijian Chen
Jianda Yu
Weiqiang Fan
Xiaobin Chi
Yonghai Peng
author_facet Yongbiao Chen
Hanyin Hong
Wenzheng Fang
Xia Zhang
Huachun Luo
Zhijian Chen
Jianda Yu
Weiqiang Fan
Xiaobin Chi
Yonghai Peng
author_sort Yongbiao Chen
collection DOAJ
description ObjectiveExposing tumor antigens to the immune system is the key to ensuring the efficacy of immunotherapy. SBRT is the main way to reveal the specifical antigens of tumors which can enhance the immune response. We aimed to explore the clinical efficacy and safety of Toripalimab combined with Anlotinib for uHCC after SBRT.MethodsThis is a prospective, single-arm, explorative clinical study. uHCC patients with an ECOG PS score of 0–1, Child–Pugh class A or B, and BCLC stage B or C were included and treated with SBRT(8Gy*3) followed by 6-cycle combinational therapy with Toripalimab and Anlotinib. The primary endpoint was progression-free survival (PFS) and the secondary endpoints were objective response rate (ORR), disease control rate (DCR), overall survival (OS), and incidence of treatment-related adverse events (TRAEs). Continuous variables were presented as medians and ranges. Survivals were studied with the Kaplan-Meier method. Categorical data were expressed as n (percentage).ResultsBetween June 2020 and October 2022, a total of 20 patients with intermediate-advanced uHCC were enrolled. All cases had multiple intrahepatic metastases, or macrovascular invasion, or both, among whom 5 cases with lymph node or distant metastases. Until September 2022, the median follow-up time was 7.2 months (range, 1.1-27.7 months). Median survival time could not be assessed at the moment, based on iRecist, median PFS was 7.4 months (range, 1.1-27.7 months), ORR 15.0%, and DCR 50.0%. 14 patients experienced treatment-related adverse events with an incidence of 70%. The overall survival rates at 18 months and 24 months were 61.1% and 50.9%, respectively. And the progression-free survival rates were 39.3% and 19.7%.ConclusionExposure of specific antigens of HCC via SBRT may improve the efficacy of combinational therapy with Toripalimab and Anlotinib for uHCC with manageable adverse effects, which deserves further exploration.Clinical trial registrationwww.clinicaltrials.gov, identifier ChiCTR2000032533.
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spelling doaj.art-024c2b8724d3468f81330cdd74e4ecb72023-03-17T05:12:55ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-03-011310.3389/fonc.2023.11133891113389Toripalimab in combination with Anlotinib for unresectable hepatocellular carcinoma after SBRT: A prospective, single-arm, single-center clinical studyYongbiao Chen0Hanyin Hong1Wenzheng Fang2Xia Zhang3Huachun Luo4Zhijian Chen5Jianda Yu6Weiqiang Fan7Xiaobin Chi8Yonghai Peng9Department of Hepatobiliary Surgery, 900 Hospital of the Joint Logistics Support Force, Fuzhou, ChinaFuzong Clinical Medical College, Fujian Medical University, Fuzhou, ChinaDepartment of Oncology, 900 Hospital of the Joint Logistics Support Force, Fuzhou, ChinaDepartment of Hepatobiliary Disease, 900 Hospital of the Joint Logistics Support Force, Fuzhou, ChinaDepartment of Radiology, 900 Hospital of the Joint Logistics Support Force, Fuzhou, ChinaDepartment of Hepatobiliary Surgery, 900 Hospital of the Joint Logistics Support Force, Fuzhou, ChinaFuzong Clinical Medical College, Fujian Medical University, Fuzhou, ChinaMedical Oncology of Cangshan Hospital Area, 900 Hospital of the Joint Logistics Support Force, Fuzhou, ChinaDepartment of Hepatobiliary Surgery, 900 Hospital of the Joint Logistics Support Force, Fuzhou, ChinaMedical Oncology of Cangshan Hospital Area, 900 Hospital of the Joint Logistics Support Force, Fuzhou, ChinaObjectiveExposing tumor antigens to the immune system is the key to ensuring the efficacy of immunotherapy. SBRT is the main way to reveal the specifical antigens of tumors which can enhance the immune response. We aimed to explore the clinical efficacy and safety of Toripalimab combined with Anlotinib for uHCC after SBRT.MethodsThis is a prospective, single-arm, explorative clinical study. uHCC patients with an ECOG PS score of 0–1, Child–Pugh class A or B, and BCLC stage B or C were included and treated with SBRT(8Gy*3) followed by 6-cycle combinational therapy with Toripalimab and Anlotinib. The primary endpoint was progression-free survival (PFS) and the secondary endpoints were objective response rate (ORR), disease control rate (DCR), overall survival (OS), and incidence of treatment-related adverse events (TRAEs). Continuous variables were presented as medians and ranges. Survivals were studied with the Kaplan-Meier method. Categorical data were expressed as n (percentage).ResultsBetween June 2020 and October 2022, a total of 20 patients with intermediate-advanced uHCC were enrolled. All cases had multiple intrahepatic metastases, or macrovascular invasion, or both, among whom 5 cases with lymph node or distant metastases. Until September 2022, the median follow-up time was 7.2 months (range, 1.1-27.7 months). Median survival time could not be assessed at the moment, based on iRecist, median PFS was 7.4 months (range, 1.1-27.7 months), ORR 15.0%, and DCR 50.0%. 14 patients experienced treatment-related adverse events with an incidence of 70%. The overall survival rates at 18 months and 24 months were 61.1% and 50.9%, respectively. And the progression-free survival rates were 39.3% and 19.7%.ConclusionExposure of specific antigens of HCC via SBRT may improve the efficacy of combinational therapy with Toripalimab and Anlotinib for uHCC with manageable adverse effects, which deserves further exploration.Clinical trial registrationwww.clinicaltrials.gov, identifier ChiCTR2000032533.https://www.frontiersin.org/articles/10.3389/fonc.2023.1113389/fullToripalimabAnlotinibstereotactic body radiotherapy (SBRT)unresectable hepatocellular carcinoma (uHCC)clinical trial
spellingShingle Yongbiao Chen
Hanyin Hong
Wenzheng Fang
Xia Zhang
Huachun Luo
Zhijian Chen
Jianda Yu
Weiqiang Fan
Xiaobin Chi
Yonghai Peng
Toripalimab in combination with Anlotinib for unresectable hepatocellular carcinoma after SBRT: A prospective, single-arm, single-center clinical study
Frontiers in Oncology
Toripalimab
Anlotinib
stereotactic body radiotherapy (SBRT)
unresectable hepatocellular carcinoma (uHCC)
clinical trial
title Toripalimab in combination with Anlotinib for unresectable hepatocellular carcinoma after SBRT: A prospective, single-arm, single-center clinical study
title_full Toripalimab in combination with Anlotinib for unresectable hepatocellular carcinoma after SBRT: A prospective, single-arm, single-center clinical study
title_fullStr Toripalimab in combination with Anlotinib for unresectable hepatocellular carcinoma after SBRT: A prospective, single-arm, single-center clinical study
title_full_unstemmed Toripalimab in combination with Anlotinib for unresectable hepatocellular carcinoma after SBRT: A prospective, single-arm, single-center clinical study
title_short Toripalimab in combination with Anlotinib for unresectable hepatocellular carcinoma after SBRT: A prospective, single-arm, single-center clinical study
title_sort toripalimab in combination with anlotinib for unresectable hepatocellular carcinoma after sbrt a prospective single arm single center clinical study
topic Toripalimab
Anlotinib
stereotactic body radiotherapy (SBRT)
unresectable hepatocellular carcinoma (uHCC)
clinical trial
url https://www.frontiersin.org/articles/10.3389/fonc.2023.1113389/full
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