Portal vein tumour thrombosis radiotherapy improves the treatment outcomes of immunotherapy plus bevacizumab in hepatocellular carcinoma: a multicentre real-world analysis with propensity score matching

作者全名："Tang, Cuiping; He, Qin; Feng, Jian; Liao, Ziyue; Peng, Yunli; Gao, Jian"

作者地址："[Tang, Cuiping; Liao, Ziyue; Gao, Jian] Chongqing Med Univ, Affiliated Hosp 2, Dept Gastroenterol & Hepatol, Chongqing, Peoples R China; [Tang, Cuiping] Chongqing Med Univ, Clin Coll 2, Dept Grad, Chongqing, Peoples R China; [He, Qin] SiChuan Mianyang 404 Hosp, Peoples Hosp 1, Dept Gastroenterol & Hepatol, Mianyang, Sichuan, Peoples R China; [Feng, Jian] Chongqing Med Univ, Bishan Hosp, Dept Oncol, Chongqing, Peoples R China; [Peng, Yunli] Chongqing Med Univ, Bishan Hosp, Dept Gastroenterol & Hepatol, Chongqing, Peoples R China"

通信作者："Gao, J (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Dept Gastroenterol & Hepatol, Chongqing, Peoples R China."

来源：FRONTIERS IN IMMUNOLOGY

ESI学科分类：IMMUNOLOGY

WOS号：WOS:001095826800001

JCR分区：Q1

影响因子：7.3

年份：2023

卷号：14

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：hepatocellular carcinoma; portal vein tumour thrombosis; radiotherapy; immune checkpoint inhibitors; bevacizumab

摘要："Background: This study aimed to evaluate the efficacy and safety of sequential immune checkpoint inhibitors (ICIs) plus bevacizumab therapy after radiotherapy for portal vein tumour thrombosis (PVTT) in patients with hepatocellular carcinoma (HCC).Methods: Retrospective data were collected from 113 patients with HCC with PVTT. Patients in the PVTT radiotherapy (radiotherapy + ICIs + bevacizumab) and control groups (ICIs + bevacizumab) were enrolled according to propensity score matching (PSM) analysis (1:1). The differences in progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and potential factors affecting PFS between the groups were analysed. The adverse events (AEs) were compared between the two groups.Results: There were 47 patients in the two groups after PSM (1:1). The differences in neutrophil and lymphocyte counts, neutrophil-to-lymphocyte ratio (NLR), CRP, and CD4, CD8, and CD4-to-CD8 ratio before and after radiotherapy for PVTT (P < 0.05) in the PVTT radiotherapy group were significant. The patients in the PVTT radiotherapy group had a longer PFS (median, 9.6 vs. 5.4 months, P < 0.001), and the PFS rates of 3, 6, 9, and 12 months were 97.87% vs. 94.19%, 80.85% vs. 44.68%, 53.19% vs. 6.38%, and 23.40% vs. 0.00%, respectively (P < 0.001). There were also significant differences in the ORR (48.94% vs. 27.66%, P = 0.0339) and DCR (97.87% vs. 82.98%, P = 0.0141) between the two groups, and no serious AEs were observed. Multivariate Cox analysis showed that AFP expression, gross classification of HCC, PVTT type, extrahepatic metastasis, PVTT radiotherapy, and reduction in PVTT were independent factors influencing PFS (P < 0.05).Conclusions: Sequential ICIs plus bevacizumab therapy after radiotherapy for PVTT in patients with HCC is safe and feasible and may further prolong the PFS of patients."

基金机构："The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the National Natural Science Foundation of China (Grant 82173359), Basic Research and Frontier Exploration Pro [82173359]; National Natural Science Foundation of China [cstc2018jcyjAX0181]; Basic Research and Frontier Exploration Project of Chongqing and Technology Commission; Kuanren Talents Program of the Second affiliatedhospital of Chongqing Medical University"

基金资助正文："The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the National Natural Science Foundation of China (Grant 82173359), Basic Research and Frontier Exploration Project of Chongqing and Technology Commission (cstc2018jcyjAX0181), and Kuanren Talents Program of the Second affiliatedhospital of Chongqing Medical University."