中国普通外科杂志2025，Vol.34Issue(7)：1382-1389,8.DOI:10.7659/j.issn.1005-6947.250300
肝动脉灌注化疗联合贝伐珠单抗+信迪利单抗与阿替利珠单抗在晚期肝细胞癌中的疗效与安全性比较
Efficacy and safety of hepatic arterial infusion chemotherapy plus bevacizumab with sintilimab vs.atezolizumab in advanced hepatocellular carcinoma
唐翔 1杨周添 1胡利 1彭威 1叶志炜 1胡丹旦 1王骏成 1张耀军1
作者信息
- 1. 中山大学肿瘤防治中心 肝脏外科,广东 广州 510060
- 折叠
摘要
Abstract
Background and Aims:In recent years,with the continuous progress of systemic therapy,hepatic arterial infusion chemotherapy(HAIC)combined with immune checkpoint inhibitors and anti-angiogenic agents has demonstrated significant efficacy in the treatment of advanced hepatocellular carcinoma(HCC).However,direct comparisons between different immunotherapeutic targets,such as PD-1 and PD-L1 inhibitors,in terms of clinical benefit and safety remain limited.This study aimed to compare the efficacy and safety of HAIC plus bevacizumab and sintilimab(HAIC-BP1)versus HAIC plus bevacizumab and atezolizumab(HAIC-BPL)in advanced HCC.
Methods:A retrospective analysis was conducted on 88 patients with advanced HCC who received first-line HAIC-BP1or HAIC-BPL at Sun Yat-sen University Cancer Center between January 2020 and December 2022.Progression-free survival(PFS),overall survival(OS),objective response rate(ORR),disease control rate(DCR),and adverse events(AEs)were compared between the two groups.Cox regression analysis was performed to identify prognostic factors affecting PFS.
Results:A total of 47 patients were included in the HAIC-BP1 group and 41 patients in the HAIC-BPL group,with no statistically significant differences in baseline characteristics between the two groups(all P>0.05).The ORR(59.6%vs.65.9%)and DCR(72.3%vs.80.5%)did not significantly differ between the HAIC-BP1 group and the HAIC-BPL group(both P>0.05).After a median follow-up of 16.3 months,there were no significant differences in median OS(21.3 months vs.22.4 months)or median PFS(6.7 months vs.6.2 months)between the HAIC-BP1 group and the HAIC-BPL group(both P>0.05).The incidence of AEs was similar,and no treatment-related deaths occurred.Multivariate Cox regression analysis identified tumor diameter>10 cm as an independent adverse prognostic factor for PFS(HR=0.48,95%CI=0.27-0.83,P=0.009).
Conclusion:Both HAIC-BP1 and HAIC-BPL demonstrated comparable efficacy and favorable safety profiles as first-line treatment options for advanced HCC.Tumor diameter>10 cm was an independent unfavorable prognostic factor for PFS,underscoring the importance of patient stratification in clinical decision-making.关键词
癌,肝细胞/化学疗法,肿瘤,局部灌注/免疫检查点抑制剂/贝伐单抗Key words
Carcinoma,Hepatocellular/Chemotherapy,Cancer,Regional Perfusion/Immune Checkpoint Inhibitors/Bevacizumab分类
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唐翔,杨周添,胡利,彭威,叶志炜,胡丹旦,王骏成,张耀军..肝动脉灌注化疗联合贝伐珠单抗+信迪利单抗与阿替利珠单抗在晚期肝细胞癌中的疗效与安全性比较[J].中国普通外科杂志,2025,34(7):1382-1389,8.
