TACE联合卡瑞利珠单抗治疗中晚期肝细胞癌

目的 观察TACE联合卡瑞利珠单抗治疗中晚期肝细胞癌(HCC)的有效性和安全性。方法 纳入42例接受TACE联合卡瑞利珠单抗治疗的中晚期HCC患者(联合组),采用倾向性评分匹配法选择另外42例仅接受TACE治疗的中晚期HCC患者作为对照组,比较组间客观缓解率(ORR)及疾病控制率(DCR)差异;随访至2022年2月11日,记录患者总生存期(OS)、无进展生存期(PFS)及不良反应发生率。结果 联合组与对照组ORR分别为61.90%(26/42)及35.71%(15/42),DCR分别为92.86%(39/42)和69.05%(29/42),差异均有统计学意义(P均<0.05)。随访时间为2.5~26.2个月,中位时间为20.2个月;联合组中位OS(19.3个月)长于对照组(13.6个月),差异有统计学意义(P=0.009)。联合组发生死亡事件的相对风险(HR)为0.456,即加用卡瑞利珠单抗使死亡风险降低54.40%。联合组中位PFS(12.9个月)长于对照组(8.4个月),差异有统计学意义(P=0.029),联合组复发HR为0.579,即加用卡瑞利珠单抗使复发风险降低42.10%。联合组29例(29/42,69.05%)出现与卡瑞利珠单抗相关的反应性皮肤毛细血管增生症,但均为1级不良反应,未出现3/4级不良反应,无因不良反应而停药病例。结论 TACE联合卡瑞利珠单抗治疗中晚期HCC安全、有效。

TACE combined with camrelizumab for treatment of advanced hepatocellular carcinoma

Objective To observe the efficacy and safety of TACE combined with camrelizumab for treatment of advanced hepatocellular carcinoma (HCC). Methods Totally 42 patients with advanced HCC who received TACE combined with camrelizumab were enrolled in combined group, while other 42 patients who underwent TACE alone and selected using propensity score matching method were enrolled in control group. The objective response rate (ORR) and disease control rate (DCR) were compared between groups. The overall survival (OS), progression free survival (PFS) and the incidence of adverse events uptill February 11, 2022 were recorded. Results ORR of combined group and control group was 61.90% (26/42) and 35.71% (15/42), DCR was 92.86% (39/42) and 69.05% (29/42), respectively, all were significantly different (both P<0.05). The followed-up time ranged from 2.5 to 26.2 months, with the median of 20.2 months. The median OS in combined group was 19.3 months, longer than that in control group (13.6 months), and the difference was significant (P=0.009). The hazard ratio (HR) of death in combined group was 0.456, indicating that the addition of camrelizumab reduced the risk of death by 54.40%. The median PFS of the combined group was 12.9 months, longer than that of control group (8.4 months), and the difference was significant (P=0.029). HR of recurrence in combined group was 0.579, indicating that the addition of camrelizumab reduced the risk of HCC recurrence by 42.10%. In combined group, 29 cases (29/42, 69.05%) had reactive cutaneous capillary endothelial proliferation related to carelizumab, but all were grade 1 adverse reactions, no grade 3/4 adverse reactions, and no one stopped the drug due to adverse reactions. Conclusion TACE combined with camrelizumab was safe and effective for treating advanced HCC.