文章：

阿特珠单抗联合贝伐珠单抗治疗不可切除肝细胞癌后仑伐替尼的疗效与安全性评估

Therapeutic Efficacy and Safety of Lenvatinib after Atezolizumab Plus Bevacizumab for Unresectable Hepatocellular Carcinoma

原文发布日期：14 November 2023

DOI: 10.3390/cancers15225406

类型: Article

开放获取: 是

英文摘要：

A total of 137 HCC patients treated with atezolizumab plus bevacizumab from October 2020 to September 2022 were enrolled. The median overall survival (OS) and progression-free survival (PFS) from the beginning of atezolizumab plus bevacizumab were 21.1 months (range, 18.8 months–not reached) and 10.5 months (range, 8.2–12.1 months), respectively. Fifty patients were diagnosed with progressive disease after atezolizumab plus bevacizumab. Of this group, 24 patients were administered lenvatinib, and the median OS and PFS from the beginning of lenvatinib were 15.3 months (range, 10.5 months–not reached) and 4.0 months (range, 2.5–6.4 months), respectively. The objective response rates based on the response evaluation criteria in solid tumors (RECISTs) criteria version 1.1 and modified RECISTs were 33.3% and 54.2%, respectively. There was no significant difference in the median serum alpha-fetoprotein level between before and after lenvatinib. In the multivariate analysis, Child–Pugh class A (hazard ratio 0.02, 95% confidence interval (CI) 0.02–0.76,p= 0.02) and intrahepatic tumor occupancy rate < 50% (hazard ratio < 0.01, 95% CI 0.003–0.35,p< 0.01) were the significant factors for OS. There were some frequent adverse events (AEs) in patients treated with lenvatinib such as hypertension, fatigue, anorexia, proteinuria, and so on, but none directly caused death. In conclusion, lenvatinib after atezolizumab plus bevacizumab for unresectable HCC should be considered an effective treatment option.

摘要翻译： 

本研究共纳入2020年10月至2022年9月期间接受阿替利珠单抗联合贝伐珠单抗治疗的137例肝细胞癌患者。从开始阿替利珠单抗联合贝伐珠单抗治疗起，中位总生存期和无进展生存期分别为21.1个月（范围：18.8个月至未达到）和10.5个月（范围：8.2-12.1个月）。其中50例患者在阿替利珠单抗联合贝伐珠单抗治疗后出现疾病进展。该亚组中24例患者接受了仑伐替尼治疗，从开始仑伐替尼治疗起，中位总生存期和无进展生存期分别为15.3个月（范围：10.5个月至未达到）和4.0个月（范围：2.5-6.4个月）。根据实体瘤疗效评价标准1.1版和改良版标准评估的客观缓解率分别为33.3%和54.2%。仑伐替尼治疗前后血清甲胎蛋白中位水平无显著差异。多变量分析显示，Child-Pugh A级（风险比0.02，95%置信区间0.02-0.76，p=0.02）和肝内肿瘤负荷率<50%（风险比<0.01，95%置信区间0.003-0.35，p<0.01）是影响总生存期的显著因素。仑伐替尼治疗患者常见不良事件包括高血压、乏力、厌食、蛋白尿等，但无直接导致死亡的不良事件。结论表明，对于不可切除肝细胞癌患者，在阿替利珠单抗联合贝伐珠单抗治疗后使用仑伐替尼应被视为有效的治疗选择。

原文链接：

Therapeutic Efficacy and Safety of Lenvatinib after Atezolizumab Plus Bevacizumab for Unresectable Hepatocellular Carcinoma