PMID- 37660471
OWN - NLM
STAT- MEDLINE
DCOM- 20231129
LR  - 20231129
IS  - 1748-880X (Electronic)
IS  - 0007-1285 (Print)
IS  - 0007-1285 (Linking)
VI  - 96
IP  - 1150
DP  - 2023 Oct
TI  - Transarterial chemoembolization plus lenvatinib with or without a PD-1 inhibitor 
      for advanced and metastatic intrahepatic cholangiocarcinoma: a retrospective 
      real-world study.
PG  - 20230079
LID - 10.1259/bjr.20230079 [doi]
LID - 20230079
AB  - OBJECTIVES: Most patients with intrahepatic cholangiocarcinoma (ICC) present with 
      locally advanced or metastatic disease. We report the combined potency of 
      transarterial chemoembolization (TACE), lenvatinib and programmed cell death-1 
      (PD-1) inhibitors in patients with advanced and metastatic ICC. METHODS: This 
      retrospective study enrolled 32 patients with advanced or metastatic ICC between 
      January 2017 and August 2021. Eligible patients had received gemcitabine-based 
      TACE combined with lenvatinib with or without PD-1 inhibitor in any line of 
      treatment. Overall survival (OS) and progression-free survival (PFS) were 
      estimated using the Kaplan-Meier method. Risk factors associated with OS were 
      assessed using univariate and multivariate Cox regression analyses. RESULTS: 
      Eighteen patients received a combination of TACE and lenvatinib (TL group) and 14 
      patients received TACE and lenvatinib plus aPD-1 inhibitor (TLP group). The 
      median follow-up time was 19.8 months (range 1.8-37.8). The median OS was 25.3 
      months (95% CI 18.5-32.1) and the median PFS was 7.3 months (95% CI 4.9-9.7). 
      Partial response was achieved in 10 patients (31.3%), and stable disease in 13 
      (40.6 %) with disease control rate of 71.9%. The median OS was comparable in the 
      TL and TLP groups (22.4 vs 27.3 months, respectively; hazard ratio: 1.245, 95% CI 
      0.4245-3.653; p = 0.687). The regression analysis revealed that, regardless of 
      treatment group, a favorable independent prognostic factor for OS was HBV/HCV 
      infection (HR: 0.063, 95% CI 0.009-0.463; p = 0.007). There were no 
      treatment-related deaths and 81.3% of study participants experienced adverse 
      events (AEs), the majority of which were of moderate severity (71.8% Grade 1-2). 
      CONCLUSIONS: Gemcitabine-based TACE plus lenvatinib with or without aPD-1 
      inhibitor was well tolerated and provided promising therapeutic outcomes for 
      patients with advanced and metastatic ICC. ADVANCES IN KNOWLEDGE: Monotherapy 
      with TACE, or Lenvatinib, or PD-1 inhibitors has shown limited efficacy over 
      standard first-line chemotherapy in advanced and metastatic ICC. This work 
      suggested the combined potency of these treatments and well-tolerance.
FAU - Ning, Zhouyu
AU  - Ning Z
AD  - Department of Integrative Oncology, Fudan University Shanghai Cancer Center, 
      Shanghai, China.
AD  - Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 
      China.
FAU - Xie, Lin
AU  - Xie L
AD  - Department of Integrative Oncology, Fudan University Shanghai Cancer Center, 
      Shanghai, China.
AD  - Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 
      China.
FAU - Yan, Xia
AU  - Yan X
AD  - Department of Integrative Oncology, Fudan University Shanghai Cancer Center, 
      Shanghai, China.
AD  - Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 
      China.
FAU - Hua, Yongqiang
AU  - Hua Y
AD  - Department of Integrative Oncology, Fudan University Shanghai Cancer Center, 
      Shanghai, China.
AD  - Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 
      China.
FAU - Shi, Weidong
AU  - Shi W
AD  - Department of Integrative Oncology, Fudan University Shanghai Cancer Center, 
      Shanghai, China.
AD  - Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 
      China.
FAU - Lin, Junhua
AU  - Lin J
AD  - Department of Integrative Oncology, Fudan University Shanghai Cancer Center, 
      Shanghai, China.
AD  - Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 
      China.
FAU - Xu, Litao
AU  - Xu L
AD  - Department of Integrative Oncology, Fudan University Shanghai Cancer Center, 
      Shanghai, China.
AD  - Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 
      China.
FAU - Meng, Zhiqiang
AU  - Meng Z
AD  - Department of Integrative Oncology, Fudan University Shanghai Cancer Center, 
      Shanghai, China.
AD  - Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 
      China.
LA  - eng
PT  - Journal Article
DEP - 20230903
PL  - England
TA  - Br J Radiol
JT  - The British journal of radiology
JID - 0373125
RN  - 0 (Immune Checkpoint Inhibitors)
RN  - EE083865G2 (lenvatinib)
RN  - 0 (Gemcitabine)
SB  - IM
MH  - Humans
MH  - Immune Checkpoint Inhibitors
MH  - Retrospective Studies
MH  - *Carcinoma, Hepatocellular/therapy
MH  - *Chemoembolization, Therapeutic
MH  - *Liver Neoplasms/therapy
MH  - *Cholangiocarcinoma/therapy
MH  - Gemcitabine
MH  - *Bile Duct Neoplasms/therapy
MH  - Bile Ducts, Intrahepatic
PMC - PMC10546439
EDAT- 2023/09/04 00:41
MHDA- 2023/11/29 06:42
PMCR- 2024/10/01
CRDT- 2023/09/03 18:03
PHST- 2024/10/01 00:00 [pmc-release]
PHST- 2023/11/29 06:42 [medline]
PHST- 2023/09/04 00:41 [pubmed]
PHST- 2023/09/03 18:03 [entrez]
AID - 10.1259/bjr.20230079 [doi]
PST - ppublish
SO  - Br J Radiol. 2023 Oct;96(1150):20230079. doi: 10.1259/bjr.20230079. Epub 2023 Sep 
      3.