Microwave ablation combined with apatinib and camrelizumab in patients with advanced hepatocellular carcinoma: A single-arm, preliminary study
PurposeThe aim of this study was to assess the safety and efficacy of microwave ablation combined with apatinib [vascular endothelial growth factor receptor-2 (VEGFR-2) inhibitor] and camrelizumab [anti-programmed death-1 (PD-1) antibody] in patients with advanced hepatocellular carcinoma (HCC).Pati...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2022.1023983/full |
| _version_ | 1828139393030815744 |
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| author | Xin Li Qiao Zhang Qiaorui Lu Zhigang Cheng Fangyi Liu Zhiyu Han Xiaoling Yu Jie Yu Ping Liang |
| author_facet | Xin Li Qiao Zhang Qiaorui Lu Zhigang Cheng Fangyi Liu Zhiyu Han Xiaoling Yu Jie Yu Ping Liang |
| author_sort | Xin Li |
| collection | DOAJ |
| description | PurposeThe aim of this study was to assess the safety and efficacy of microwave ablation combined with apatinib [vascular endothelial growth factor receptor-2 (VEGFR-2) inhibitor] and camrelizumab [anti-programmed death-1 (PD-1) antibody] in patients with advanced hepatocellular carcinoma (HCC).Patients and methodsPatients (age, >18 years) with histologically confirmed HCC and refractory to at least the standard first-line therapy were enrolled from 2 September 2018 to 17 January 2022. They first received ultrasound-guided subtotal microwave ablation. Then, beginning at 7–14 days after ablation, they were given apatinib (250 mg once daily) and camrelizumab (200 mg once every 2 weeks) until unacceptable toxicity or disease progression or death. The coprimary end points were progression-free survival (PFS) and overall survival (OS).ResultsFourteen HCC patients with Barcelona Clinic of Liver Cancer (BCLC) B and C stages were retrospectively enrolled. At data cutoff, follow-up period ranged from 3.8 to 41.3 months (median, 17.4 months), and the median (95% confidence interval) duration of exposure (DE) was 6.4 (4.0–8.9) months. The PFS and OS were 10.8 (0–23.5) months and 19.3 (2.4–36.2) months, respectively. Three (21.4%) patients achieved a confirmed complete response (CR). Confirmed partial response (PR), stable disease (SD), and progression of disease (PD) were achieved in four (28.6%), four (28.6%), and three (21.4%) patients, respectively. The objective response rate (ORR) and disease control rate (DCR) were 50.0% (20.0%-80.0%) and 78.6% (54.0%-100%), respectively. The serious treatment-related adverse events included one (7.1%) case with reactive capillary hemangiomas (grade 4), one (7.1%) with hypertension (grade 3), two (14.3%) with elevated transaminase and bilirubin (grade 4), one (7.1%) with platelet count decrease (grade 4), one (7.1%) with hepatic failure (grade 4), and two (14.3%) with gastrointestinal bleeding (grades 3 and 4).ConclusionsMicrowave ablation combined with apatinib and camrelizumab treatment in advanced HCC patients demonstrated intriguing clinical activity and resulted in durable antitumor responses and significantly improved PFS and OS. The combination therapy is well tolerated, enabling further clinical studies. |
| first_indexed | 2024-04-11T18:50:56Z |
| format | Article |
| id | doaj.art-aa53af7d32d04deaaefc472bc6e7ab5f |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-04-11T18:50:56Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-aa53af7d32d04deaaefc472bc6e7ab5f2022-12-22T04:08:21ZengFrontiers Media S.A.Frontiers in Immunology1664-32242022-10-011310.3389/fimmu.2022.10239831023983Microwave ablation combined with apatinib and camrelizumab in patients with advanced hepatocellular carcinoma: A single-arm, preliminary studyXin Li0Qiao Zhang1Qiaorui Lu2Zhigang Cheng3Fangyi Liu4Zhiyu Han5Xiaoling Yu6Jie Yu7Ping Liang8Department of Interventional Ultrasound, The Fifth Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, ChinaDepartment of Ultrasound, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, ChinaDepartment of Ultrasound, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, ChinaDepartment of Interventional Ultrasound, The Fifth Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, ChinaDepartment of Interventional Ultrasound, The Fifth Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, ChinaDepartment of Interventional Ultrasound, The Fifth Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, ChinaDepartment of Interventional Ultrasound, The Fifth Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, ChinaDepartment of Interventional Ultrasound, The Fifth Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, ChinaDepartment of Interventional Ultrasound, The Fifth Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, ChinaPurposeThe aim of this study was to assess the safety and efficacy of microwave ablation combined with apatinib [vascular endothelial growth factor receptor-2 (VEGFR-2) inhibitor] and camrelizumab [anti-programmed death-1 (PD-1) antibody] in patients with advanced hepatocellular carcinoma (HCC).Patients and methodsPatients (age, >18 years) with histologically confirmed HCC and refractory to at least the standard first-line therapy were enrolled from 2 September 2018 to 17 January 2022. They first received ultrasound-guided subtotal microwave ablation. Then, beginning at 7–14 days after ablation, they were given apatinib (250 mg once daily) and camrelizumab (200 mg once every 2 weeks) until unacceptable toxicity or disease progression or death. The coprimary end points were progression-free survival (PFS) and overall survival (OS).ResultsFourteen HCC patients with Barcelona Clinic of Liver Cancer (BCLC) B and C stages were retrospectively enrolled. At data cutoff, follow-up period ranged from 3.8 to 41.3 months (median, 17.4 months), and the median (95% confidence interval) duration of exposure (DE) was 6.4 (4.0–8.9) months. The PFS and OS were 10.8 (0–23.5) months and 19.3 (2.4–36.2) months, respectively. Three (21.4%) patients achieved a confirmed complete response (CR). Confirmed partial response (PR), stable disease (SD), and progression of disease (PD) were achieved in four (28.6%), four (28.6%), and three (21.4%) patients, respectively. The objective response rate (ORR) and disease control rate (DCR) were 50.0% (20.0%-80.0%) and 78.6% (54.0%-100%), respectively. The serious treatment-related adverse events included one (7.1%) case with reactive capillary hemangiomas (grade 4), one (7.1%) with hypertension (grade 3), two (14.3%) with elevated transaminase and bilirubin (grade 4), one (7.1%) with platelet count decrease (grade 4), one (7.1%) with hepatic failure (grade 4), and two (14.3%) with gastrointestinal bleeding (grades 3 and 4).ConclusionsMicrowave ablation combined with apatinib and camrelizumab treatment in advanced HCC patients demonstrated intriguing clinical activity and resulted in durable antitumor responses and significantly improved PFS and OS. The combination therapy is well tolerated, enabling further clinical studies.https://www.frontiersin.org/articles/10.3389/fimmu.2022.1023983/fullmicrowave ablationapatinibcamrelizumabcombination therapeutic strategyadvanced hepatocellular carcinoma |
| spellingShingle | Xin Li Qiao Zhang Qiaorui Lu Zhigang Cheng Fangyi Liu Zhiyu Han Xiaoling Yu Jie Yu Ping Liang Microwave ablation combined with apatinib and camrelizumab in patients with advanced hepatocellular carcinoma: A single-arm, preliminary study Frontiers in Immunology microwave ablation apatinib camrelizumab combination therapeutic strategy advanced hepatocellular carcinoma |
| title | Microwave ablation combined with apatinib and camrelizumab in patients with advanced hepatocellular carcinoma: A single-arm, preliminary study |
| title_full | Microwave ablation combined with apatinib and camrelizumab in patients with advanced hepatocellular carcinoma: A single-arm, preliminary study |
| title_fullStr | Microwave ablation combined with apatinib and camrelizumab in patients with advanced hepatocellular carcinoma: A single-arm, preliminary study |
| title_full_unstemmed | Microwave ablation combined with apatinib and camrelizumab in patients with advanced hepatocellular carcinoma: A single-arm, preliminary study |
| title_short | Microwave ablation combined with apatinib and camrelizumab in patients with advanced hepatocellular carcinoma: A single-arm, preliminary study |
| title_sort | microwave ablation combined with apatinib and camrelizumab in patients with advanced hepatocellular carcinoma a single arm preliminary study |
| topic | microwave ablation apatinib camrelizumab combination therapeutic strategy advanced hepatocellular carcinoma |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2022.1023983/full |
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