PMID- 38482216 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240315 IS - 2078-6891 (Print) IS - 2219-679X (Electronic) IS - 2078-6891 (Linking) VI - 15 IP - 1 DP - 2024 Feb 29 TI - Hepatic arterial infusion chemotherapy combined with bevacizumab plus a PD-1 inhibitor for gallbladder cancer with hepatic oligometastasis: a real-world study. PG - 330-345 LID - 10.21037/jgo-23-816 [doi] AB - BACKGROUND: Gallbladder cancer (GBC) is different from other biliary tract cancers in terms of molecular phenotype and microenvironment. Specific treatments for GBC need to be urgently explored. This study preliminarily investigated the clinical value of hepatic artery infusion chemotherapy (HAIC) combined with bevacizumab plus a programmed death receptor-1 (PD-1) inhibitor for treatment of GBC with hepatic oligometastasis. METHODS: We retrospectively collected data on GBC patients with hepatic oligometastasis, who received this combination therapy. The clinical data, conversion rate, treatment response, adverse events (AEs), and short-term survival were summarized. The responses of primary gallbladder lesions and hepatic metastasis, and their effect on prognosis, were investigated. RESULTS: A total of 27 patients were included in the analysis. No grade 4 AEs were observed. The overall objective response rate (ORR) was 55.6% and the disease control rate (DCR) was 85.2%. Median overall survival (OS) time was 15.0 months and the 1-year survival rate was 64.0%. Median progression-free survival (PFS) time was 7.0 months and the 1-year PFS rate was 16.2%. Six patients (22.2%) were successfully converted to resection. Compared with primary gallbladder lesions, it appeared more difficult for patients with hepatic metastasis to achieve remission (ORR: 40.7% vs. 77.8%; P=0.012), but its response appeared to be closely related to the prognosis [median OS: 16.0 months in the complete response (CR) or partial response (PR) group vs. 11.0 months in the stable disease (SD) or progressive disease (PD) group, P=0.070; median PFS: 12.0 months in the CR or PR group vs. 6.5 months in the SD or PD group, P<0.001]. Preoperative CA19-9 of >1,900 U/mL and >5 cm metastatic lesions were associated with an unsatisfactory response, whereas a significant decrease of (18)F-fluorodeoxyglucose ((18)F-FDG) uptake may be a marker of tumor remission. CONCLUSIONS: The combination of HAIC, a PD-1 inhibitor, and bevacizumab shows potential for advanced GBC with hepatic oligometastasis. The therapeutic response of hepatic metastasis had a greater influence on prognosis than that of primary gallbladder lesions. CI - 2024 Journal of Gastrointestinal Oncology. All rights reserved. FAU - Zhao, Wenchao AU - Zhao W AD - Faculty of Hepato-Pancreato-Biliary Surgery, Chinese PLA General Hospital, Beijing, China. FAU - Yao, Zhiyuan AU - Yao Z AD - Faculty of Hepato-Pancreato-Biliary Surgery, Chinese PLA General Hospital, Beijing, China. AD - Medical School of Chinese PLA, Beijing, China. FAU - Li, Jingbo AU - Li J AD - Faculty of Hepato-Pancreato-Biliary Surgery, Chinese PLA General Hospital, Beijing, China. FAU - Li, Wenping AU - Li W AD - Department of Medical Imaging, the Sixth Medical Center of Chinese PLA General Hospital, Beijing, China. FAU - Dou, Qi AU - Dou Q AD - Department of Nuclear Medicine, the Sixth Medical Center of Chinese PLA General Hospital, Beijing, China. FAU - Zhao, Xiangfei AU - Zhao X AD - Department of Oncology, Chinese PLA General Hospital, Beijing, China. FAU - Wu, Yintao AU - Wu Y AD - Faculty of Hepato-Pancreato-Biliary Surgery, Chinese PLA General Hospital, Beijing, China. FAU - Xia, Nianxin AU - Xia N AD - Faculty of Hepato-Pancreato-Biliary Surgery, Chinese PLA General Hospital, Beijing, China. LA - eng PT - Journal Article DEP - 20240228 PL - China TA - J Gastrointest Oncol JT - Journal of gastrointestinal oncology JID - 101557751 PMC - PMC10932672 OTO - NOTNLM OT - Gallbladder cancer (GBC) OT - bevacizumab OT - hepatic arterial infusion chemotherapy OT - programmed death receptor-1 inhibitor (PD-1 inhibitor) COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jgo.amegroups.com/article/view/10.21037/jgo-23-816/coif). The authors have no conflicts of interest to declare. EDAT- 2024/03/14 06:46 MHDA- 2024/03/14 06:47 PMCR- 2024/02/29 CRDT- 2024/03/14 04:21 PHST- 2023/09/29 00:00 [received] PHST- 2024/01/19 00:00 [accepted] PHST- 2024/03/14 06:47 [medline] PHST- 2024/03/14 06:46 [pubmed] PHST- 2024/03/14 04:21 [entrez] PHST- 2024/02/29 00:00 [pmc-release] AID - jgo-15-01-330 [pii] AID - 10.21037/jgo-23-816 [doi] PST - ppublish SO - J Gastrointest Oncol. 2024 Feb 29;15(1):330-345. doi: 10.21037/jgo-23-816. Epub 2024 Feb 28.