Background/Objectives: Combination therapy with atezolizumab and bevacizumab (ATZ/BEV) is extremely effective and yields a high response rate in patients with hepatocellular carcinoma (HCC). In this study, the efficacy of adding locoregional therapy to ATZ/BEV in patients with stable disease (SD) HCC was investigated.Methods: One hundred five HCC patients who were treated with ATZ/BEV or lenvatinib (LEN) as first-line chemotherapy for unresectable HCC were evaluated on the basis of the modified RECIST criteria. SD patients whose initial antitumor effect was achieved received locoregional therapy, and the overall survival (OS) rate was assessed.Results: This study included 58 ATZ/BEV-treated participants and 47 LEN-treated participants. Twenty-eight SD patients (ATZ/BEV) and 20 SD patients (LEN) were identified. OS was significantly greater in ATZ/BEV-treated patients who also received locoregional therapy than in those who did not receive this additional therapy (p= 0.0343), whereas there was no difference between LEN-treated patients who also received locoregional therapy and those who did not. The locoregional therapy consisted of transcatheter arterial chemoembolization (TACE) and/or radiofrequency ablation (RFA). When assessing the add-on effect of TACE and/or RFA in the SD patients treated with ATZ/BEV, five patients were found to achieve CR.Conclusions: The addition of locoregional therapy, such as TACE/RFA, was found to affect SD patients. When a response is limited during ATZ/BEV therapy, it is important to consider the therapeutic option of adding locoregional therapy, as this additional treatment may contribute to improved prognosis via immune modulation.
背景/目的：阿替利珠单抗联合贝伐珠单抗（ATZ/BEV）治疗肝细胞癌（HCC）疗效显著，可获得较高的应答率。本研究探讨了在疾病稳定（SD）的HCC患者中，在ATZ/BEV基础上联合局部区域治疗的疗效。 方法：根据改良RECIST标准，对105例接受ATZ/BEV或仑伐替尼（LEN）作为不可切除HCC一线化疗的患者进行评估。对初始抗肿瘤疗效达到SD的患者进行局部区域治疗，并评估其总生存（OS）率。 结果：本研究纳入58例接受ATZ/BEV治疗的患者和47例接受LEN治疗的患者。其中，ATZ/BEV组有28例SD患者，LEN组有20例SD患者。在ATZ/BEV治疗组中，联合接受局部区域治疗的患者OS显著优于未接受该附加治疗的患者（p=0.0343），而LEN治疗组中联合与未联合局部区域治疗的患者OS无显著差异。局部区域治疗包括经导管动脉化疗栓塞（TACE）和/或射频消融（RFA）。在评估ATZ/BEV治疗的SD患者中联合TACE和/或RFA的附加疗效时，发现5例患者达到完全缓解（CR）。 结论：联合TACE/RFA等局部区域治疗对SD患者具有积极影响。当ATZ/BEV治疗期间应答有限时，考虑联合局部区域治疗这一治疗选择至关重要，因为该附加治疗可能通过免疫调节改善患者预后。
Efficacy of Adding Locoregional Therapy in ATZ/BEV-Treated Patients with Stable HCC
肿瘤(癌症)患者之家