乙型肝炎病毒 DNA 水平与免疫检查点抑制剂治疗下晚期乙型肝

StephenW

乙型肝炎病毒 DNA 水平与免疫检查点抑制剂治疗下晚期乙型肝炎病毒相关肝细胞癌总生存期的关系
安梦超#1、王文康#2、张杰3、Brian G Till 4、赵玲迪1、黄昊1、杨永浩1、李铁鹏1、鹿晗1、张小杰1、秦鹏1、王云健5 , 张敏 5 , 崔红 5 , 高全丽 6 , 王紫冰 7
隶属关系
隶属关系

    1
    郑州大学附属肿瘤医院&河南省肿瘤医院免疫治疗科，郑州
    2
    【作者单位】： 郑州大学第一附属医院乳腺外科;
    3
    新乡医科大学基础医学院病理教研室，新乡
    4
    美国西雅图 Fred Hutchinson 癌症研究中心临床研究部。
    5
    【作者单位】： 郑州大学附属肿瘤医院&河南省肿瘤医院肝胆外科;
    6
    郑州大学附属肿瘤医院&河南省肿瘤医院免疫治疗科，郑州[email protected]。
    7
    郑州大学附属肿瘤医院&河南省肿瘤医院免疫治疗科，郑州[email protected]。

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同等贡献。

    PMID：35907016 DOI：10.1007/s00262-022-03254-w

抽象的

背景：高水平的乙型肝炎病毒 (HBV) DNA 水平是术后 HBV 相关肝癌复发的独立危险因素。我们试图检查 HBV DNA 水平和抗病毒治疗是否与接受基于抗程序性细胞死亡蛋白 1 (PD-1) 的免疫治疗的晚期肝细胞癌 (HCC) 患者的生存结果相关。

方法：这项单机构回顾性分析包括从 2018 年 6 月 1 日至 2020 年 12 月 30 日期间接受治疗的 217 名晚期 HBV 相关 HCC 患者。比较了 HBV DNA 水平低和高的患者的基线信息。比较总生存期（OS）和无进展生存期（PFS），并应用单变量和多变量分析来确定肿瘤学结果的潜在危险因素。

结果：纳入分析的 217 名患者的中位生存时间为 20.6 个月。在这些 HBV 相关 HCC 患者中，165 名已知基线 HBV DNA 水平。基线 HBV DNA 水平与 OS (P = 0.59) 或 PFS (P = 0.098) 没有显着相关性。与未接受抗病毒治疗的患者相比，无论 HBV DNA 水平如何，接受抗病毒治疗的患者的 OS 显着改善（20.6 个月 vs 11.1 个月，P = 0.020）。此外，在对 HBV 相关 HCC 患者进行的多变量分析中，抗病毒状态（调整后的 HR = 0.24，95% CI 0.094-0.63，P = 0.004）是 OS 的独立保护因素。

结论：HBV 病毒载量不会影响接受基于抗 PD-1 的免疫治疗的 HBV 相关 HCC 患者的临床结果。抗病毒治疗的使用显着提高了 HBV 相关 HCC 患者的生存时间。

关键词：乙型肝炎病毒；肝细胞癌;免疫疗法；程序性细胞死亡蛋白-1。

© 2022。作者，获得 Springer-Verlag GmbH Germany 的独家许可，是 Springer Nature 的一部分。

StephenW

Association of hepatitis B virus DNA levels with overall survival for advanced hepatitis B virus-related hepatocellular carcinoma under immune checkpoint inhibitor therapy
Mengchao An #  1 , Wenkang Wang #  2 , Jie Zhang  3 , Brian G Till  4 , Lingdi Zhao  1 , Hao Huang  1 , Yonghao Yang  1 , Tiepeng Li  1 , Lu Han  1 , Xiaojie Zhang  1 , Peng Qin  1 , Yunjian Wang  5 , Min Zhang  5 , Hong Cui  5 , Quanli Gao  6 , Zibing Wang  7
Affiliations
Affiliations

    1
    Department of Immunotherapy, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China.
    2
    Department of Breast Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
    3
    Department of Pathology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, China.
    4
    Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, USA.
    5
    Department of Hepatobiliary Surgery, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China.
    6
    Department of Immunotherapy, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China. [email protected].
    7
    Department of Immunotherapy, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China. [email protected].

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Contributed equally.

    PMID: 35907016 DOI: 10.1007/s00262-022-03254-w

Abstract

Background: High hepatitis B virus (HBV) DNA level is an independent risk factor for postoperative HBV-associated liver cancer recurrence. We sought to examine whether HBV DNA level and antiviral therapy are associated with survival outcomes in patients with advanced hepatocellular carcinoma (HCC) treated with anti-programmed cell death protein 1 (PD-1)based immunotherapy.

Methods: This single-institution retrospective analysis included 217 patients with advanced HBV-related HCC treated from 1 June 2018, through 30 December 2020. Baseline information was compared between patients with low and high HBV DNA levels. Overall survival (OS) and progression-free survival (PFS) were compared, and univariate and multivariate analyses were applied to identify potential risk factors for oncologic outcomes.

Results: The 217 patients included in the analysis had a median survival time of 20.6 months. Of these HBV-associated HCC patients, 165 had known baseline HBV DNA levels. Baseline HBV DNA level was not significantly associated with OS (P = 0.59) or PFS (P = 0.098). Compared to patients who did not receive antiviral therapy, patients who received antiviral therapy had significantly better OS (20.6 vs 11.1 months, P = 0.020), regardless of HBV DNA levels. Moreover, antiviral status (adjusted HR = 0.24, 95% CI 0.094-0.63, P = 0.004) was an independent protective factor for OS in a multivariate analysis of patients with HBV-related HCC.

Conclusions: HBV viral load does not compromise the clinical outcome of patients with HBV-related HCC treated with anti-PD-1-based immunotherapy. The use of antiviral therapy significantly improves survival time of HBV-related HCC patients.

Keywords: Hepatitis B virus; Hepatocellular carcinoma; Immunotherapy; Programmed cell death protein-1.

© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.