PMID- 36591442
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230103
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 12
DP  - 2022
TI  - Prognostic efficacy and prognostic factors of TACE plus TKI with ICIs for the 
      treatment of unresectable hepatocellular carcinoma: A retrospective study.
PG  - 1029951
LID - 10.3389/fonc.2022.1029951 [doi]
LID - 1029951
AB  - Hepatocellular carcinoma (HCC) remains a global challenge due to its high 
      morbidity and mortality rates as well as poor response to treatment. Local 
      combined systemic therapy is widely used in the treatment of unresectable 
      hepatocellular cancer (uHCC). This retrospective study was to investigate the 
      prognostic effect and prognostic factors of transcatheter arterial 
      chemoembolization (TACE) plus tyrosine kinase inhibitors (TKI) with immune 
      checkpoint inhibitors (ICIs) in the treatment of uHCC. A retrospective analysis 
      of 171 patients with uHCC was performed in our hospital from April 27, 2015 to 
      October 18, 2021. According to different treatment options, patients were divided 
      into TACE group (n=45), TACE+TKI group (n=76) and TACE+TKI+ICIs group (n=50). In 
      this study, we found that, the median overall survival (mOS) of TACE+TKI+ICIs 
      group was significantly better than TACE+TKI group and TACE group [24.1 (95% CI 
      15.1-33.1) months vs 14.9 (95% CI 10.7-19.1) months vs 11.4 (95% CI 8.4-14.5) 
      months, hazard ratio (HR) 0.62; 95% CI 0.47-0.81; P=0.002]. A visible difference 
      in the median progression-free survival (mPFS) interval between the groups was 
      discovered [10.6 (95% CI6.5-14.7) months in TACE+TKI+ICIs group vs. 6.7 (95% CI 
      5.5-7.9) months in the TACE+TKI group vs. 6 (95% CI 2.3-9.7) months in the TACE 
      group (HR 0.66; 95% CI 0.53-0.83; P<0.001)]. The objective response rates (ORR) 
      in the TACE group, TACE+TKI group, and TACE+TKI+ICIs group were 31.1%, 35.5%, and 
      42%, and the disease control rate (DCR) were 51.1%, 65.8%, and 80%. There were no 
      adverse events (AEs) of arthralgia, diarrhea, rash, and pruritus in the TACE 
      group. The incidence of grade 3 AEs (Hypertension) in the TACE+TKI+ICIs group was 
      significantly higher than that in TACE+TKI and TACE groups (28% vs 17.1% vs 6.7%, 
      P=0.024), and secondly, the morbidity of rash and pruritus in the TACE+TKI+ICIs 
      group was apparently higher than that in the TACE+TKI group (P<0.05). 
      Multivariate analysis showed that ECOG-PS 2 (HR=2.064, 95%CI 1.335-3.191, 
      P=0.001), Hepatitis B virus (HR=2.539, 95%CI 1.291-4.993, P=0.007), AFP>/=400 ng/ml 
      (HR= 1.72, 95%CI 1.12-2.643, P=0.013), neutrophil-lymphocyte ratio (NLR) >/=2.195 
      (HR=1.669, 95%CI 1.073-2.597, P=0.023) were independent risk factors for OS in 
      uHCC patients. So, TACE+TKI+ICIs therapy can prolong the OS and improve the 
      prognosis of patients effectively, with a well-characterized safety profile.
CI  - Copyright (c) 2022 Han, Yang, Zhang, Wang, Ni, Zhu, Zhou, Gao and Lu.
FAU - Han, Ziqiang
AU  - Han Z
AD  - Department of Hepatobiliary Surgery, Shandong Provincial Hospital affiliated to 
      Shandong First Medical University, Jinan, Shandong, China.
FAU - Yang, Faji
AU  - Yang F
AD  - Department of Hepatobiliary Surgery, Shandong Provincial Hospital affiliated to 
      Shandong First Medical University, Jinan, Shandong, China.
FAU - Zhang, Ye
AU  - Zhang Y
AD  - Department of Hepatobiliary Surgery, Shandong Provincial Hospital affiliated to 
      Shandong First Medical University, Jinan, Shandong, China.
FAU - Wang, Jianlu
AU  - Wang J
AD  - Department of Hepatobiliary Surgery, Shandong Provincial Hospital affiliated to 
      Shandong First Medical University, Jinan, Shandong, China.
FAU - Ni, Qingqiang
AU  - Ni Q
AD  - Department of Hepatobiliary Surgery, Shandong Provincial Hospital affiliated to 
      Shandong First Medical University, Jinan, Shandong, China.
FAU - Zhu, Huaqiang
AU  - Zhu H
AD  - Department of Hepatobiliary Surgery, Shandong Provincial Hospital affiliated to 
      Shandong First Medical University, Jinan, Shandong, China.
FAU - Zhou, Xu
AU  - Zhou X
AD  - Department of Hepatobiliary Surgery, Shandong Provincial Hospital affiliated to 
      Shandong First Medical University, Jinan, Shandong, China.
FAU - Gao, Hengjun
AU  - Gao H
AD  - Department of Hepatobiliary Surgery, Shandong Provincial Hospital affiliated to 
      Shandong First Medical University, Jinan, Shandong, China.
FAU - Lu, Jun
AU  - Lu J
AD  - Department of Hepatobiliary Surgery, Shandong Provincial Hospital affiliated to 
      Shandong First Medical University, Jinan, Shandong, China.
LA  - eng
PT  - Journal Article
DEP - 20221215
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
PMC - PMC9798199
OTO - NOTNLM
OT  - hepatocellular carcinoma
OT  - immune checkpoint inhibitor
OT  - prognosis
OT  - transcatheter arterial chemoembolization
OT  - tyrosine kinase inhibitor
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2023/01/03 06:00
MHDA- 2023/01/03 06:01
PMCR- 2022/01/01
CRDT- 2023/01/02 04:55
PHST- 2022/08/28 00:00 [received]
PHST- 2022/12/05 00:00 [accepted]
PHST- 2023/01/02 04:55 [entrez]
PHST- 2023/01/03 06:00 [pubmed]
PHST- 2023/01/03 06:01 [medline]
PHST- 2022/01/01 00:00 [pmc-release]
AID - 10.3389/fonc.2022.1029951 [doi]
PST - epublish
SO  - Front Oncol. 2022 Dec 15;12:1029951. doi: 10.3389/fonc.2022.1029951. eCollection 
      2022.