Radiotherapy enhances efficacy of PD-1 inhibitors in advanced hepatocellular carcinoma:A propensity-matched real-world studyOACSTPCDMEDLINE
Radiotherapy enhances efficacy of PD-1 inhibitors in advanced hepatocellular carcinoma:A propensity-matched real-world study
Background:To address the need for immunotherapy in patients with advanced primary hepatocellular carcinoma(HCC),com-bination with radiotherapy(RT)has emerged as a promising strategy.In preclinical studies,irradiated tumors released tumor antigens to synergistically increase the antitumor effect of immunotherapy.Hence,we investigated whether RT enhances the efficacy of anti-programmed death receptor-1(PD-1)inhibitors in advanced HCC in real-world practice. Methods:Between August 2018 and June 2021,172 patients with advanced primary HCC were enrolled in the tertiary center(Zhongshan Hospital of.Fudan University);95 were treated with a combination of RT and the inhibitor of PD-1(RT-PD1 cohort),and 77 were administered anti-PD-1 therapy(PD1 cohort).The first cycle of PD-1 inhibitors was administered within 60 days or concurrently with RT.Propensity score matching for bias reduction was used to evaluate the clinical outcomes. Results:Among 71 propensity-matched pairs,median progression-free survival was 5.7 months in the RT-PD1 cohort vs.2.9 months in the PD1 cohort(P<0.001).Median overall survival was 20.9 months in the RT-PD1 cohort vs.11.2 months in the PD1 cohort(P=0.018).Compared with patients in the PD1 cohort,patients in the RT-PD1 cohort had significantly higher objective response rates(40.8%,29/71 vs.19.7%,14/71,P=0.006)and disease control rates(62.0%,44/71 vs.31.0%,22/71,P<0.001).The incidences of toxic effects were not significantly different between the two cohorts. Conclusions:RT plus anti-PD-1 therapy is well tolerated.RT enhances the efficacy of anti-PD-1 therapy in patients with advanced primary HCC by improving survival outcomes without increased toxic effects.
Shujung Hsu;Yencheng Chao;Yong Hu;Yang Zhang;Weifeng Hong;Yixing Chen;Rongxin Chen;Zhaochong Zeng;Shisuo Du
Department of Radiation Oncology,Zhongshan Hospital,Fudan University,Shanghai 200032,ChinaDepartment of Pulmonary Medicine,Zhongshan Hospital,Fudan University,Shanghai 200032,ChinaDepartment of Liver Cancer Institute,Zhongshan Hospital,Fudan University,Shanghai 200032,China
RadiotherapyImmune checkpoint inhibitorProgrammed cell death receptor-1Hepatocellular carcinomaPropensity score matchingTreatment outcomeAdverse effects
《中华医学杂志(英文版)》 2024 (011)
1332-1342 / 11
This study was supported a grant from the National Natu-ral Science Foundation of China(No.82073479).
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