Organ specific responses to first-line lenvatinib plus anti-PD-1 antibodies in patients with unresectable hepatocellular carcinoma: a retrospective analysis.
Organ specific responses to first-line lenvatinib plus anti-PD-1 antibodies in patients with unresectable hepatocellular carcinoma: a retrospective analysis.
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不可切除的肝细胞癌患者对一线乐伐替尼联合抗 PD-1 抗体的器官特异性反应：回顾性分析
DOI：
10.1186/s40364-021-00274-z
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发表时间：
2021-03-20
影响因子：
11.1
通讯作者：
Sun HC
中科院分区：
文献类型：
--
作者：
Huang C;Zhu XD;Shen YH;Wu D;Ji Y;Ge NL;Chen LL;Tan CJ;Zhou J;Fan J;Sun HC
背景我们评估了晚期肝细胞癌（HCC）患者对一线乐伐替尼联合抗PD-1抗体的器官特异性应答率（OSRRs）。MethodsThis回顾性分析包括2018年10月至2020年5月期间接受一线乐伐替尼（8 mg/天）联合≥3次抗PD-1抗体输注的不可切除/晚期HCC中国患者。每2个月使用RECIST v1.1评价一次肿瘤和大血管肿瘤血栓（MVTT）治疗缓解。总反应率（ORR）/OSRR被定义为患者的最佳总体反应的完全或部分反应（CR或PR）的百分比。结果在总数中，60例患者被纳入分析; 96.7%有可测量的肝内病变，55%有MVTT和26.7%有肝外疾病。在所有60例患者中，ORR为33.3%，中位无进展生存期为7.0个月（95% CI，1.7-12.3），未达到中位总生存期。MVTT的OSRR（54.5%）高于肝内肿瘤（32.8%）、肝外肺转移（37.5%）和淋巴结转移（33.3%）。在33例肝内肿瘤和MVTT患者中，18例在每个部位有不同的反应，包括13例MVTT比肝内病变的反应更好。在18例MVTT达到放射学CR或PR的患者中，6例接受了手术切除：4/6例在MVTT中达到病理学CR，2/6例在肝内tumor.ConclusionsFirst-line Lenvatinib加抗PD-1抗体导致MVTT与肝内病变相比更好的肿瘤反应。完全的MVTT坏死可能会使一部分晚期HCC患者的分期降低，随后有资格接受手术切除。
BackgroundWe evaluated organ-specific response rates (OSRRs) to first-line lenvatinib plus anti-PD-1 antibodies in patients with advanced hepatocellular carcinoma (HCC).MethodsThis retrospective analysis included Chinese patients with unresectable/advanced HCC who received first-line lenvatinib (8 mg/day) plus ≥3 infusions of anti-PD-1 antibodies between October 2018 and May 2020. Tumor and macrovascular tumor thrombi (MVTT) treatment responses were evaluated every 2 months using RECIST v1.1. The overall response rate (ORR)/OSRR was defined as the percentage of patients with a best overall response of complete or partial response (CR or PR).ResultsIn total, 60 patients were included in the analysis; 96.7% had measurable intrahepatic lesions, 55% had MVTT and 26.7% had extrahepatic disease. In all 60 patients, the ORR was 33.3%, median progression-free survival was 7.0 months (95% CI, 1.7–12.3) and median overall survival was not reached. The OSRR for MVTT (54.5%) was higher versus intrahepatic tumors (32.8%), extrahepatic lung metastases (37.5%) and lymph node metastases (33.3%). Among 33 patients with intrahepatic tumors and MVTT, 18 had differential responses in each site, including 13 with a better response in MVTT versus intrahepatic lesions. Among 18 patients whose MVTT achieved a radiographic CR or PR, six underwent surgical resection: 4/6 achieved a pathological CR in MVTT and 2/6 in the intrahepatic tumor.ConclusionsFirst-line lenvatinib plus anti-PD-1 antibodies resulted in better tumor responses in MVTT versus intrahepatic lesions. Complete MVTT necrosis may allow downstaging and subsequent eligibility for surgical resection in a proportion of patients with advanced HCC.
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影响因子：
8.4
作者：
Eisenhauer, E. A.;Therasse, P.;Verweij, J.
通讯作者：
Verweij, J.
影响因子：
158.5
作者：
Llovet, Josep M.;Ricci, Sergio;Bruix, Jordi
通讯作者：
Bruix, Jordi
影响因子：
11.5
作者：
Xu, Jianming;Shen, Jie;Wang, Quanren
通讯作者：
Wang, Quanren
影响因子：
45.3
作者：
Finn, Richard S.;Ikeda, Masafumi;Llovet, Josep M.
通讯作者：
Llovet, Josep M.
影响因子：
11.5
作者：
Hoy, Sheridan M.
通讯作者：
Hoy, Sheridan M.