Nivolumab聯合化學療法或多靶酪氨酸激酶抑製劑在復發性乙型

StephenW

Clinical Outcomes and Prognosis Factors of Nivolumab Plus Chemotherapy or Multitarget Tyrosine Kinase Inhibitor in Multi-Line Therapy for Recurrent Hepatitis B Virus-Related Hepatocellular Carcinoma: A Retrospective Analysis
Chao Chen  1 , Li An  2 , Ying Cheng  1 , Xianwen Luo  1 , Zixiong Li  1 , Xiufeng Liu  1
Affiliations

    PMID: 32983970 PMCID: PMC7479184 DOI: 10.3389/fonc.2020.01404

Abstract

Background: This study investigates the potential predictors of nivolumab plus chemotherapy or multitarget tyrosine kinase inhibitor (TKI) treatment response in patients with recurrent hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). Methods: Patients with recurrent hepatitis B virus-related HCC who underwent nivolumab plus chemotherapy or TKI treatment between July 2017 and June 2019 at Jinling Hospital in China were retrospectively evaluated and included in this study. These patients also had both complete medical charts and follow-up data available. Overall survival (OS) and progression-free survival (PFS) were calculated from the date of nivolumab initiation. Survival data were compared using log-rank tests, and the associations of patient characteristics with survival were estimated using Cox regression models. Results: A total of 22 HCC patients were included in this cohort and constituted the basis for this analysis. Twenty progressed cases (91%) and 16 deaths (73%) were identified at a median follow-up of 8.8 months (range 1-25). The median OS from the time of nivolumab initiation was 10.7 months (95% CI, 0.8-20.6 months), with a median PFS of 5.1 months (95% CI, 3.1-7.0 months). The patients were divided into two risk groups according to a nomogram built by age, Eastern Cooperative Oncology Group (ECOG) status, hepatectomy status, and transarterial chemoembolization (TACE) use. The median PFS was 8.2 ± 2.8 months in the low-risk group compared with 1.9 ± 0.4 months in the high-risk group (p = 0.0018). The median OS was estimated as 16.8 ± 4.9 months for low-risk patients vs. 8.6 ± 3.5 months for high-risk patients (p = 0.13). Conclusion: Nivolumab combined with chemotherapy or TKI treatment is effective in patients with recurrent hepatitis B virus-related HCC. It is observed that previous TACE treatment is associated with a better PFS, and worse PFS in those patients who received hepatectomy. Prospective studies are warranted to evaluate the effects of nivolumab combined chemotherapy or TKI on recurrent hepatitis B virus-related HCC.

Keywords: chemotherapy; hepatitis B virus; hepatocellular carcinoma; nivolumab; programmed cell death protein 1; tyrosine kinase inhibitor.

Copyright © 2020 Chen, An, Cheng, Luo, Li and Liu.

StephenW

Nivolumab聯合化學療法或多靶酪氨酸激酶抑製劑在復發性乙型肝炎病毒相關肝細胞癌多系治療中的臨床結果和預後因素：回顧性分析
陳超1，李安2，應成1，羅先文1，李自雄1，劉秀峰1
隸屬關係

    PMID：32983970 PMCID：PMC7479184 DOI：10.3389 / fonc.2020.01404

抽象

背景：本研究調查了復發性乙型肝炎病毒（HBV）相關的肝細胞癌（HCC）患者中尼古魯單抗聯合化療或多靶酪氨酸激酶抑製劑（TKI）治療反應的潛在預測因素。方法：回顧性評估2017年7月至2019年6月在中國金陵醫院接受尼古魯單抗加化療或TKI治療的複發性乙型肝炎病毒相關性HCC患者，並將其納入本研究。這些患者還具有完整的醫療圖表和可用的隨訪數據。從納武單抗開始之日起計算總生存期（OS）和無進展生存期（PFS）。使用對數秩檢驗比較生存數據，並使用Cox回歸模型評估患者特徵與生存的關聯。結果：該隊列共納入22例HCC患者，構成了該分析的基礎。在中位隨訪時間為8.8個月（範圍1-25）中，確定了20例進展病例（91％）和16例死亡（73％）。起始於納武單抗開始時的中位OS為10.7個月（95％CI，0.8-20.6個月），中位PFS為5.1個月（95％CI，3.1-7.0個月）。根據按年齡劃分的列線圖，將患者分為兩個風險組：東方合作腫瘤組（ECOG）狀態，肝切除術狀態和經動脈化學栓塞（TACE）。低風險組的中位PFS為8.2±2.8個月，而高風險組為1.9±0.4個月（p = 0.0018）。低危患者的中位OS估計為16.8±4.9個月，而高危患者為8.6±3.5個月（p = 0.13）。結論：Nivolumab聯合化療或TKI治療對於復發性乙型肝炎病毒相關性HCC患者有效。觀察到先前的TACE治療與那些接受肝切除術的患者的PFS更好，而PFS較差有關。必須進行前瞻性研究來評估尼古魯單抗聯合化療或TKI對複發性乙型肝炎病毒相關HCC的影響。

關鍵詞：化學療法；乙型肝炎病毒;肝細胞癌；尼伏魯單抗;程序性細胞死亡蛋白1；酪氨酸激酶抑製劑。

©2020 Chen，An，Cheng，Luo，Li and Liu版權所有。

StephenW

https://www.frontiersin.org/articles/10.3389/fonc.2020.01404/pdf