文章：

不可切除肝细胞癌靶向治疗中的不良事件可预测临床结局

Adverse Events in Targeted Therapy for Unresectable Hepatocellular Carcinoma Predict Clinical Outcomes

原文发布日期：14 September 2024

DOI: 10.3390/cancers16183150

类型: Article

开放获取: 是

英文摘要：

To assess the impact of adverse event (AE) severity, caused by targeted therapy, on overall survival (OS) and progression-free survival (PFS) in patients with unresectable hepatocellular carcinoma (HCC), a total of 183 patients with HCC treated with atezolizumab plus bevacizumab (40), lenvatinib (57), sorafenib (79), cabozantinib (3), ramucirumab (3), and regorafenib (1) were included in this study. Age-, AFP-, and ALBI score-adjusted hazard ratios (HRs) of AE grades 1 to 3 versus grade 0 for OS and PFS were calculated using Cox proportional hazards models. The linear trend of the HRs was assessed by calculating thepvalues for this trend. The most common AEs were appetite loss (AE grade 0/1/2/3 = 97/23/55/12), general fatigue (102/31/44/6), hypertension (120/6/40/17), hand-foot syndrome (HFS) (135/21/24/3), proteinuria (140/13/16/14), and hypothyroidism (148/12/23/0). The adjusted HRs for OS of these AEs were 0.532–1.450–2.361 (pfor trend 0.037), 1.057–1.691–3.364 (pfor trend 0.004), 1.176–0.686–0.281 (pfor trend 0.002), 0.639–0.759–1.820 (pfor trend 0.462), 1.030–0.959–0.147 (pfor trend 0.011), and 0.697–0.609 (pfor trend 0.119), respectively. Those for PFS of the corresponding AEs were 0.592–1.073–2.811 (pfor trend 0.255), 1.161–1.282–4.324 (pfor trend 0.03), 0.965–0.781–0.655 (pfor trend 0.095), 0.737–0.623–2.147 (pfor trend 0.153), 1.061–0.832–0.800 (pfor trend 0.391), and 1.412–0.560 (pfor trend 0.081), respectively. Appetite loss and general fatigue negatively affected clinical outcomes, whereas hypertension, HFS, proteinuria, and hypothyroidism had positive effects.

摘要翻译： 

为评估靶向治疗所致不良事件（AE）的严重程度对不可切除肝细胞癌（HCC）患者总生存期（OS）和无进展生存期（PFS）的影响，本研究共纳入183例接受阿替利珠单抗联合贝伐珠单抗（40例）、仑伐替尼（57例）、索拉非尼（79例）、卡博替尼（3例）、雷莫西尤单抗（3例）和瑞戈非尼（1例）治疗的HCC患者。通过Cox比例风险模型计算经年龄、甲胎蛋白（AFP）和ALBI评分校正后，AE 1-3级相对于0级对OS和PFS的风险比（HR），并计算趋势p值以评估HR的线性趋势。最常见的AE包括食欲减退（AE 0/1/2/3级=97/23/55/12例）、全身乏力（102/31/44/6例）、高血压（120/6/40/17例）、手足综合征（135/21/24/3例）、蛋白尿（140/13/16/14例）和甲状腺功能减退（148/12/23/0例）。这些AE对OS的校正HR分别为0.532–1.450–2.361（趋势p=0.037）、1.057–1.691–3.364（趋势p=0.004）、1.176–0.686–0.281（趋势p=0.002）、0.639–0.759–1.820（趋势p=0.462）、1.030–0.959–0.147（趋势p=0.011）和0.697–0.609（趋势p=0.119）；对PFS的校正HR分别为0.592–1.073–2.811（趋势p=0.255）、1.161–1.282–4.324（趋势p=0.03）、0.965–0.781–0.655（趋势p=0.095）、0.737–0.623–2.147（趋势p=0.153）、1.061–0.832–0.800（趋势p=0.391）和1.412–0.560（趋势p=0.081）。食欲减退和全身乏力对临床结局产生负面影响，而高血压、手足综合征、蛋白尿和甲状腺功能减退则呈现积极影响。

原文链接：

Adverse Events in Targeted Therapy for Unresectable Hepatocellular Carcinoma Predict Clinical Outcomes