卡瑞利珠单抗联合沙利度胺治疗晚期肝细胞癌的疗效及安全性
《现代肿瘤医学》[ISSN:1672-4992/CN:61-1415/R]
- 期数:
- 2022年12期
- 页码:
- 2201-2204
- 栏目:
- 论著（消化肿瘤）
- 出版日期:
- 2022-05-12
文章信息/Info
- Title:
- Safety and efficacy of camrelizumab combined with thalidomide for advanced hepatocellular carcinoma
- Author(s):
- REN Huiwen; LIU Jinyang; WU Lixia; GU Ningning; HAN Zhengxiang
- Department of Oncology,Affiliated Hospital of Xuzhou Medical University,Jiangsu Xuzhou 221002,China.
- Keywords:
- camrelizumab; thalidomide; immunotherapy; hepatocellular carcinoma
- 分类号:
- R735.7
- DOI:
- 10.3969/j.issn.1672-4992.2022.12.018
- 文献标识码:
- A
- 摘要:
- 目的：评估卡瑞利珠单抗联合沙利度胺在晚期肝细胞癌患者中的疗效和安全性。方法：收集2019年7月至2020年7月既往全身治疗进展或不耐受的晚期肝细胞癌患者24例，给予卡瑞利珠单抗200 mg静脉滴注，每3周给药1次；沙利度胺100 mg起始，1周后增至200 mg，每晚1次口服。评价疗效及安全性。结果：共24例患者纳入研究，其中1例完全缓解，8例部分缓解，9例疾病稳定，4例疾病进展，客观缓解率为37.5%（9/24），疾病控制率为75.0%（18/24）。2例患者在随访期间死亡，死亡原因为疾病进展导致的多器官衰竭，中位PFS为6.5个月（95%CI,5.15~7.85）。最常见的不良反应是反应性皮肤毛细血管增生症（41.7%）、血小板减少（33.4%）、γ-谷氨酰转肽酶升高（25.0%）、白细胞减少（20.8%）和转氨酶升高（29.2%），1例3级血小板减少事件，2例3级转氨酶升高事件，未发现4级及以上的不良反应。结论：卡瑞利珠单抗联合沙利度胺在晚期肝细胞癌患者中显示出一定的疗效和可控的安全性。对于既往全身治疗进展或不耐受的晚期肝细胞癌患者来说，这可能代表了一种新的治疗选择。
- Abstract:
- Objective:To investigate the safety and clinical efficacy of camrelizumab combined with thalidomide in the treatment of advanced hepatocellular carcinoma.Methods:From July 2019 to July 2020,the clinical data of 24 patients with advanced hepatocellular carcinoma who had progressed on or were intolerant to previous systemic treatment were reviewed.All the patients received intravenous camrelizumab 200 mg every 3 weeks,oral thalidomide 100 mg every night and increased to 200 mg after one week.The efficacy and safety were evaluated comprehensively.Results:A total of 24 patients were finally enrolled in this research.There were 1 case of complete response,8 cases of partial response,9 cases of stable disease and 4 cases of progressive disease．The objective response rate was 37.5%(9/24).The disease control rate was 75.0%(18/24).2 patients died with multiple organ failure due to disease progression during follow-up.The median PFS was 6.5 months (95%CI,5.15~7.85).The most common treatment-related adverse events (AEs) were reactive cutaneous capillary endothelial proliferation (RCCEP)(41.7%),thrombocytopenia (33.4%),increased γ-glutamyltransferase (25.0%),decreased white blood cell (20.8%) and increased aminotransferase (29.2%).There were 1 case of grade 3 thrombocytopenia and 2 cases of grade 3 increased aminotransferase.No grade 4 AEs was observed.Conclusion:Camrelizumab combined with thalidomide showed promising efficacy and manageable safety in patients with advanced hepatocellular carcinoma.It might represent a novel treatment option for these patients with HCC who had progressed on or were intolerant to previous systemic treatment.
参考文献/References
［1］ QIU WQ,SHI JF,GUO LW,et al.Medical expenditure for liver cancer in urban China:A 10-year multicenter retrospective survey (2002-2011) ［J］.J Cancer Res Ther,2018,14:163-170.
［2］ BRAY F,FERLAY J,SOERJOMATARAM I,et al.Global cancer statistics 2018:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries ［J］.CA Cancer J Clin,2018,68:394-424.
［3］ BALOGH J,VICTOR D,ASHAM EH,et al.Hepatocellular carcinoma:a review ［J］.J Hepatocell Carcinoma,2016,3:41-53.
［4］ ZENG H,CHEN W,ZHENG R,et al.Changing cancer survival in China during 2003-15:a pooled analysis of 17 population-based cancer registries ［J］.Lancet Glob Health,2018,6:e555-567.
［5］ SIEGEL RL,MILLER KD,JEMAL A.Cancer statistics,2018 ［J］.CA Cancer J Clin,2018,68:7-30.
［6］ LURJE I,CZIGANY Z,BEDNARSCH J,et al.Treatment strategies for hepatocellular carcinoma-A multidisciplinary approach ［J］.Int J Molecular Sci,2019,20:1465.
［7］ XU J,ZHANG Y,JIA R,et al.Anti-PD-1 antibody SHR-1210 combined with apatinib for advanced hepatocellular carcinoma,gastric,or esophagogastric junction cancer:an open-label,dose escalation and expansion study ［J］.Clin Cancer Res,2019,25(2):515-523.
［8］ YANG JD,HAINAUT P,GORES GJ,et al.A global view of hepatocellular carcinoma:trends,risk,prevention and management ［J］.Nat Rev Gastroenterol Hepatol,2019,16:589-604.
［9］ LU W,JIN XL,YANG C,et al.Comparison of efficacy between TACE combined with apatinib and TACE alone in the treatment of intermediate and advanced hepatocellular carcinoma:A single-center randomized controlled trial ［J］.Cancer Biol Ther,2017,18:433-438.
［10］ MARKHAM A,KEAM SJ.Camrelizumab:first global approval ［J］.Drugs,2019,79:1355-1361.
［11］ ZAK K,KITEL R,PRZETOCKA S,et al.Structure of the complex of human programmed death 1,PD-1,and its ligand PD-L1 ［J］.Structure,2015,23(12):2341-2348.
［12］ QIN SK,REN ZG,MENG ZQ,et al.Camrelizumab in patients with previously treated advanced hepatocellular carcinoma:a multicentre,open-label,parallel-group,randomised,phase 2 trial ［J］.Lancet Oncol,2020,21(4):571-580.
［13］ XU JM,SHEN J,GU SZ,et al.Camrelizumab in combination with apatinib in patients with advanced hepatocellular carcinoma (RESCUE):a non-randomized,open-label,phase 2 trial［J］.Clin Cancer Res,2021,27(4):1003-1011.
［14］ ZHOU CC,GAO GH,WU FY,et al.A phase Ib study of SHR-1210 plus apatinib for heavily previously treated advanced nonsquamous non-small cell lung cancer (NSCLC) patients ［J］.J Clin Oncol,2018,36(15 Suppl):e21017.
［15］ SALEMI M,MOHAMMADI S,GHAVAMZADEH A,et al.Anti-vascular endothelial growth factor targeting by curcumin and thalidomide in acute myeloid leukemia cells［J］.Asian Pac J Cancer Prev,2017,18(11):3055-3061.
［16］ 王泽鑫.分析沙利度胺对原发性肝癌介入后血管内皮生长因子及生存质量的影响［J］.世界最新医学信息文摘,2018,18(84):76-79.
WANG ZX.The effect of thalidomide on vascular endothelial growth factor and quality of life in primary hepatic carcinoma after transcatheter arterial chemoembolization［J］.World Lasted Medicine Information,2018,18(84):76-79.
［17］ 况晶茹，徐骏，胡迎宾，等.沙利度胺治疗晚期胃癌患者对于血管内皮生长因子及肿瘤坏死因子-α的影响研究［J］.中国医刊,2014,49(12):66-68.
KUANG JR,XU J,HU YB,et al.Effect of thalidomide on vascular endothelial growth factor and tumor necrosis factor-α in patients with advanced gastric cancer［J］.China Academic,2014,49(12):66-68.
［18］ CHEN YY,YEN HH,CHOU KC,et al.Thalidomide-based multidisciplinary treatment for patients with advanced hepatocellular carcinoma:A retrospective analysis ［J］.World J Gastroenterol,2012,18(5):466-471.
［19］ LEE SJ,LEE SY,LEE WS,et al.Phase I trial and pharmacokinetic study of tanibirumab,a fully human monoclonal antibody tovascular endothelial growth factor receptor 2,in patients with refractory solid tumors ［J］.Invest New Drugs,2017,35(6):782-790.
备注/Memo
- 备注/Memo:
- 江苏省高层次卫生人才六个一工程(编号：LGY2020006）
