Risk of HBV reactivation in HCC patients undergoing combination therapy of PD-1 inhibitors and angiogenesis inhibitors in the antiviral era

作者全名："Wang, Rui; Tan, Guili; Lei, Dingjia; Li, Yadi; Gong, Jiaojiao; Tang, Yao; Pang, Hao; Luo, Huating; Qin, Bo"

作者地址："[Wang, Rui; Tan, Guili; Li, Yadi; Gong, Jiaojiao; Tang, Yao; Pang, Hao; Qin, Bo] Chongqing Med Univ, Affiliated Hosp 1, Dept Infect Dis, Chongqing, Peoples R China; [Luo, Huating] Chongqing Med Univ, Affiliated Hosp 1, Dept Geriatr, Chongqing, Peoples R China; [Lei, Dingjia] Chengdu Med Coll, China Natl Nucl Corp Hosp 416, Affiliated Hosp 2, Dept Resp & Crit Care Med, Chengdu, Peoples R China"

通信作者："Qin, B (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Infect Dis, Chongqing, Peoples R China.; Luo, HT (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Geriatr, Chongqing, Peoples R China."

来源：JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001191354500002

JCR分区：Q3

影响因子：2.7

年份：2024

卷号：150

期号：3

开始页：　

结束页：　

文献类型：Article

关键词：HBV reactivation; Immune checkpoint inhibitor (ICI); PD-1; Combination therapy; Angiogenesis inhibitor

摘要："Background Although routine antiviral therapy has been implemented in HCC patients, the risk of HBV reactivation (HBVr) remains with the use of programmed cell death-1(PD-1) blockade-based combination immunotherapy and the relevant risk factors are also unclear. Therefore, we aimed to identify the incidence and risk factors of HBVr in HCC patients undergoing combination therapy of PD-1 inhibitors and angiogenesis inhibitors and concurrent first-line antivirals.Methods We included a total of 218 HBV-related HCC patients with first-line antivirals who received PD-1 inhibitors alone or together with angiogenesis inhibitors. According to the anti-tumor therapy modalities, patients were divided into PD-1 inhibitors monotherapy group (anti-PD-1 group) and combination therapy group (anti-PD-1 plus angiogenesis inhibitors group). The primary study endpoint was the incidence of HBVr.Results HBVr occurred in 16 (7.3%) of the 218 patients, 2 cases were found in the anti-PD-1 group and the remaining 14 cases were in the combination group. The Cox proportional hazard model identified 2 independent risk factors for HBVr: combination therapy (hazard ratio [HR], 4.608, 95%CI 1.010-21.016, P = 0.048) and hepatitis B e antigen (HBeAg) positive (HR, 3.695, 95%CI 1.246-10.957, P = 0.018). Based on the above results, we developed a simple risk-scoring system and found that the high-risk group (score = 2) developed HBVr more frequently than the low-risk group (score = 0) (Odds ratio [OR], 17.000, 95%CI 1.946-148.526, P = 0.01). The area under the ROC curve (AUC-ROC) was 7.06 (95%CI 0.581-0.831, P = 0.006).Conclusion HBeAg-positive patients receiving combination therapy have a 17-fold higher risk of HBVr than HBeAg-negative patients with PD-1 inhibitors monotherapy."

基金机构：Natural Science Foundation of Chongqing Municipality

基金资助正文：No Statement Available