Hepatic arterial infusion chemotherapy combined with PD-1 inhibitors and tyrosine kinase inhibitors for unresectable hepatocellular carcinoma: A tertiary medical center experience
BackgroundUnresectable hepatocellular carcinoma (u-HCC) still accounts for the majority of newly diagnosed HCC which with poor prognosis. In the era of systemic therapy, combination therapy with programmed cell death protein-1 (PD-1) inhibitors and tyrosine kinase inhibitors (TKIs) has become mainst...
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| Format: | Article |
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.1004652/full |
| _version_ | 1811208594261016576 |
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| author | Laihui Luo Yongqiang Xiao Guoqing Zhu Aihong Huang Shengjiang Song Tao Wang Xian Ge Jin Xie Wei Deng Zhigao Hu Wu Wen Haoran Mei Renhua Wan Renfeng Shan |
| author_facet | Laihui Luo Yongqiang Xiao Guoqing Zhu Aihong Huang Shengjiang Song Tao Wang Xian Ge Jin Xie Wei Deng Zhigao Hu Wu Wen Haoran Mei Renhua Wan Renfeng Shan |
| author_sort | Laihui Luo |
| collection | DOAJ |
| description | BackgroundUnresectable hepatocellular carcinoma (u-HCC) still accounts for the majority of newly diagnosed HCC which with poor prognosis. In the era of systemic therapy, combination therapy with programmed cell death protein-1 (PD-1) inhibitors and tyrosine kinase inhibitors (TKIs) has become mainstream. Hepatic arterial infusion chemotherapy (HAIC) as a local treatment has also shown a strong anti-tumor effect. This study aimed to investigate the efficacy and safety of HAIC, PD-1 inhibitors plus TKIs for u-HCC.MethodsThis retrospective study included patients with initially u-HCC between October 2020 to April 2022 who had received at least one cycle of therapy with HAIC, PD-1 inhibitors plus TKIs. The primary outcome included overall response rate (ORR), the disease control rate (DCR), surgical conversion rate, progression-free survival (PFS) and treatment-related adverse events.ResultsA total of 145 patients were included in the study. The median treatment cycle of HAIC and PD-1 inhibitors were 3 and 4, respectively. According to the modified RECIST criteria, the best ORR was 57.2% (83/145), 9 had achieved complete response (CR), DCR was 89.7% (130/145). Median time to achieve CR or PR was 65 days. Surgical conversion rate was 18.6% (27/145), seven patients (7/27,25.9%) achieved pathological complete response (pCR). The median follow-up was 12.5 months (4.5-20 months), and the median PFS was 9.7 months. Subgroup analysis showed that Child-pugh A patients had higher DCR (92.2% vs 79.3%, p=0.041) than Child-pugh B patients, as well as increased successful conversion rate (22.4% vs 3.4%, p=0.019). Patients without vascular invasion and extrahepatic metastases showed higher PR (63.4% vs 43.3%, p<0.05) and ORR (73.2% vs 50.0%, p<0.05) than those with vascular invasion. The ORR (73.2% vs 45.5%, p<0.05) and DCR (95.1% vs 78.8%, p<0.05) were also significantly better than those of patients with extrahepatic metastases. HAIC regimen was not related to efficacy (All p>0.05). The incidence rate of grade 3/4 treatment-related AEs was 17.7% without fatal events.ConclusionThe triple combination therapy of HAIC and PD-1 inhibitors plus TKIs for patients with initially unresectable HCC exhibited satisfactory efficacy with tolerable toxicity. |
| first_indexed | 2024-04-12T04:24:13Z |
| format | Article |
| id | doaj.art-2e2991e8b7b84fe1aa5882895c63cdd0 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-12T04:24:13Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Oncology |
| spelling | doaj.art-2e2991e8b7b84fe1aa5882895c63cdd02022-12-22T03:48:07ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-09-011210.3389/fonc.2022.10046521004652Hepatic arterial infusion chemotherapy combined with PD-1 inhibitors and tyrosine kinase inhibitors for unresectable hepatocellular carcinoma: A tertiary medical center experienceLaihui Luo0Yongqiang Xiao1Guoqing Zhu2Aihong Huang3Shengjiang Song4Tao Wang5Xian Ge6Jin Xie7Wei Deng8Zhigao Hu9Wu Wen10Haoran Mei11Renhua Wan12Renfeng Shan13Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaDepartment of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaDepartment of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaDepartment of Infectious Disease, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaDepartment of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaDepartment of Day Surgery Ward, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaDepartment of Pathology, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaDepartment of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaDepartment of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaDepartment of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaDepartment of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaDepartment of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaDepartment of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaDepartment of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaBackgroundUnresectable hepatocellular carcinoma (u-HCC) still accounts for the majority of newly diagnosed HCC which with poor prognosis. In the era of systemic therapy, combination therapy with programmed cell death protein-1 (PD-1) inhibitors and tyrosine kinase inhibitors (TKIs) has become mainstream. Hepatic arterial infusion chemotherapy (HAIC) as a local treatment has also shown a strong anti-tumor effect. This study aimed to investigate the efficacy and safety of HAIC, PD-1 inhibitors plus TKIs for u-HCC.MethodsThis retrospective study included patients with initially u-HCC between October 2020 to April 2022 who had received at least one cycle of therapy with HAIC, PD-1 inhibitors plus TKIs. The primary outcome included overall response rate (ORR), the disease control rate (DCR), surgical conversion rate, progression-free survival (PFS) and treatment-related adverse events.ResultsA total of 145 patients were included in the study. The median treatment cycle of HAIC and PD-1 inhibitors were 3 and 4, respectively. According to the modified RECIST criteria, the best ORR was 57.2% (83/145), 9 had achieved complete response (CR), DCR was 89.7% (130/145). Median time to achieve CR or PR was 65 days. Surgical conversion rate was 18.6% (27/145), seven patients (7/27,25.9%) achieved pathological complete response (pCR). The median follow-up was 12.5 months (4.5-20 months), and the median PFS was 9.7 months. Subgroup analysis showed that Child-pugh A patients had higher DCR (92.2% vs 79.3%, p=0.041) than Child-pugh B patients, as well as increased successful conversion rate (22.4% vs 3.4%, p=0.019). Patients without vascular invasion and extrahepatic metastases showed higher PR (63.4% vs 43.3%, p<0.05) and ORR (73.2% vs 50.0%, p<0.05) than those with vascular invasion. The ORR (73.2% vs 45.5%, p<0.05) and DCR (95.1% vs 78.8%, p<0.05) were also significantly better than those of patients with extrahepatic metastases. HAIC regimen was not related to efficacy (All p>0.05). The incidence rate of grade 3/4 treatment-related AEs was 17.7% without fatal events.ConclusionThe triple combination therapy of HAIC and PD-1 inhibitors plus TKIs for patients with initially unresectable HCC exhibited satisfactory efficacy with tolerable toxicity.https://www.frontiersin.org/articles/10.3389/fonc.2022.1004652/fullunresectable hepatocellular carcinomahepatic arterial infusion chemotherapyprogrammed cell death protein-1tyrosine kinase inhibitorsconversion therapy |
| spellingShingle | Laihui Luo Yongqiang Xiao Guoqing Zhu Aihong Huang Shengjiang Song Tao Wang Xian Ge Jin Xie Wei Deng Zhigao Hu Wu Wen Haoran Mei Renhua Wan Renfeng Shan Hepatic arterial infusion chemotherapy combined with PD-1 inhibitors and tyrosine kinase inhibitors for unresectable hepatocellular carcinoma: A tertiary medical center experience Frontiers in Oncology unresectable hepatocellular carcinoma hepatic arterial infusion chemotherapy programmed cell death protein-1 tyrosine kinase inhibitors conversion therapy |
| title | Hepatic arterial infusion chemotherapy combined with PD-1 inhibitors and tyrosine kinase inhibitors for unresectable hepatocellular carcinoma: A tertiary medical center experience |
| title_full | Hepatic arterial infusion chemotherapy combined with PD-1 inhibitors and tyrosine kinase inhibitors for unresectable hepatocellular carcinoma: A tertiary medical center experience |
| title_fullStr | Hepatic arterial infusion chemotherapy combined with PD-1 inhibitors and tyrosine kinase inhibitors for unresectable hepatocellular carcinoma: A tertiary medical center experience |
| title_full_unstemmed | Hepatic arterial infusion chemotherapy combined with PD-1 inhibitors and tyrosine kinase inhibitors for unresectable hepatocellular carcinoma: A tertiary medical center experience |
| title_short | Hepatic arterial infusion chemotherapy combined with PD-1 inhibitors and tyrosine kinase inhibitors for unresectable hepatocellular carcinoma: A tertiary medical center experience |
| title_sort | hepatic arterial infusion chemotherapy combined with pd 1 inhibitors and tyrosine kinase inhibitors for unresectable hepatocellular carcinoma a tertiary medical center experience |
| topic | unresectable hepatocellular carcinoma hepatic arterial infusion chemotherapy programmed cell death protein-1 tyrosine kinase inhibitors conversion therapy |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.1004652/full |
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