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Effectiveness and tolerability of camrelizumab combined with molecular targeted therapy for patients with unresectable or advanced HCC

There is a lack of effective programmed cell death protein 1 (PD-1)‐targeted immunotherapy with good tolerability in patients with advanced hepatocellular carcinoma (HCC) and severely compromised liver function. We assessed patient outcomes after combined camrelizumab and molecular targeted therapy...

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Autores principales: Li, Ting, Guo, Jiang, Liu, Yushen, Du, Zhaoqing, Guo, Zhaoyang, Fan, Yangwei, Cheng, Long, Zhang, Yue, Gao, Xu, Zhao, Yunyu, He, Xinyuan, Wu, Wenhua, Gao, Ning, Wu, Yinying, Li, Jie, Zhang, Yu, Kang, Wen, Cai, Zhifang, Wang, Wenjun, Li, Xiaopeng, Zan, Ying, Nguyen, Mindie H., Ji, Fanpu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10264531/
https://www.ncbi.nlm.nih.gov/pubmed/36840762
http://dx.doi.org/10.1007/s00262-023-03404-8
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author Li, Ting
Guo, Jiang
Liu, Yushen
Du, Zhaoqing
Guo, Zhaoyang
Fan, Yangwei
Cheng, Long
Zhang, Yue
Gao, Xu
Zhao, Yunyu
He, Xinyuan
Wu, Wenhua
Gao, Ning
Wu, Yinying
Li, Jie
Zhang, Yu
Kang, Wen
Cai, Zhifang
Wang, Wenjun
Li, Xiaopeng
Zan, Ying
Nguyen, Mindie H.
Ji, Fanpu
author_facet Li, Ting
Guo, Jiang
Liu, Yushen
Du, Zhaoqing
Guo, Zhaoyang
Fan, Yangwei
Cheng, Long
Zhang, Yue
Gao, Xu
Zhao, Yunyu
He, Xinyuan
Wu, Wenhua
Gao, Ning
Wu, Yinying
Li, Jie
Zhang, Yu
Kang, Wen
Cai, Zhifang
Wang, Wenjun
Li, Xiaopeng
Zan, Ying
Nguyen, Mindie H.
Ji, Fanpu
author_sort Li, Ting
collection PubMed
description There is a lack of effective programmed cell death protein 1 (PD-1)‐targeted immunotherapy with good tolerability in patients with advanced hepatocellular carcinoma (HCC) and severely compromised liver function. We assessed patient outcomes after combined camrelizumab and molecular targeted therapy in a multicenter cohort study in China. The study included 99 patients with advanced HCC (58 Child-Pugh A and 41 Child-Pugh B), 84 of them received camrelizumab combined with molecular targeted therapy from January 10, 2019, to March 31, 2021. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and adverse events (AEs) were assessed. The median follow-up was 12.1 months. For patients with Child-Pugh B, the OS probability at 12-months, ORR and DCR were 49.7%, 31.7% and 65.9%, respectively, and the median PFS was 5.1 months [95% confidence interval (CI) 3.0–7.1], which were comparable with Child-Pugh A patients, although median OS was shorter in Child‐Pugh B patients (20.5 vs.13.4 months, P = 0.12). In multivariate analysis, macrovascular infiltration (MVI), but not sex, age, hepatitis B virus etiology, extrahepatic metastasis, Child-Pugh B, or AFP > 400 ng/ml, was associated with 12-months OS [hazard ratio (HR) 2.970, 95% CI 1.276–6.917, P = 0.012] and ORR (HR 2.906, 95% CI 1.18–7.16, P = 0.020). Grade 3/4 immune-related AEs occurred in 26.8% of Child-Pugh B patients, including one potentially treatment-related death. In both groups, the most common AEs were immune thrombocytopenia and hepatotoxicity. Camrelizumab combined with targeted therapy showed favorable effectiveness and tolerability with manageable toxicities in Chinese HCC patients, regardless of Child-Pugh A/B liver function. MVI was associated with suboptimal immunotherapy response and poor prognosis. GRAPHICAL ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00262-023-03404-8.
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spelling pubmed-102645312023-06-15 Effectiveness and tolerability of camrelizumab combined with molecular targeted therapy for patients with unresectable or advanced HCC Li, Ting Guo, Jiang Liu, Yushen Du, Zhaoqing Guo, Zhaoyang Fan, Yangwei Cheng, Long Zhang, Yue Gao, Xu Zhao, Yunyu He, Xinyuan Wu, Wenhua Gao, Ning Wu, Yinying Li, Jie Zhang, Yu Kang, Wen Cai, Zhifang Wang, Wenjun Li, Xiaopeng Zan, Ying Nguyen, Mindie H. Ji, Fanpu Cancer Immunol Immunother Research There is a lack of effective programmed cell death protein 1 (PD-1)‐targeted immunotherapy with good tolerability in patients with advanced hepatocellular carcinoma (HCC) and severely compromised liver function. We assessed patient outcomes after combined camrelizumab and molecular targeted therapy in a multicenter cohort study in China. The study included 99 patients with advanced HCC (58 Child-Pugh A and 41 Child-Pugh B), 84 of them received camrelizumab combined with molecular targeted therapy from January 10, 2019, to March 31, 2021. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and adverse events (AEs) were assessed. The median follow-up was 12.1 months. For patients with Child-Pugh B, the OS probability at 12-months, ORR and DCR were 49.7%, 31.7% and 65.9%, respectively, and the median PFS was 5.1 months [95% confidence interval (CI) 3.0–7.1], which were comparable with Child-Pugh A patients, although median OS was shorter in Child‐Pugh B patients (20.5 vs.13.4 months, P = 0.12). In multivariate analysis, macrovascular infiltration (MVI), but not sex, age, hepatitis B virus etiology, extrahepatic metastasis, Child-Pugh B, or AFP > 400 ng/ml, was associated with 12-months OS [hazard ratio (HR) 2.970, 95% CI 1.276–6.917, P = 0.012] and ORR (HR 2.906, 95% CI 1.18–7.16, P = 0.020). Grade 3/4 immune-related AEs occurred in 26.8% of Child-Pugh B patients, including one potentially treatment-related death. In both groups, the most common AEs were immune thrombocytopenia and hepatotoxicity. Camrelizumab combined with targeted therapy showed favorable effectiveness and tolerability with manageable toxicities in Chinese HCC patients, regardless of Child-Pugh A/B liver function. MVI was associated with suboptimal immunotherapy response and poor prognosis. GRAPHICAL ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00262-023-03404-8. Springer Berlin Heidelberg 2023-02-25 2023 /pmc/articles/PMC10264531/ /pubmed/36840762 http://dx.doi.org/10.1007/s00262-023-03404-8 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research
Li, Ting
Guo, Jiang
Liu, Yushen
Du, Zhaoqing
Guo, Zhaoyang
Fan, Yangwei
Cheng, Long
Zhang, Yue
Gao, Xu
Zhao, Yunyu
He, Xinyuan
Wu, Wenhua
Gao, Ning
Wu, Yinying
Li, Jie
Zhang, Yu
Kang, Wen
Cai, Zhifang
Wang, Wenjun
Li, Xiaopeng
Zan, Ying
Nguyen, Mindie H.
Ji, Fanpu
Effectiveness and tolerability of camrelizumab combined with molecular targeted therapy for patients with unresectable or advanced HCC
title Effectiveness and tolerability of camrelizumab combined with molecular targeted therapy for patients with unresectable or advanced HCC
title_full Effectiveness and tolerability of camrelizumab combined with molecular targeted therapy for patients with unresectable or advanced HCC
title_fullStr Effectiveness and tolerability of camrelizumab combined with molecular targeted therapy for patients with unresectable or advanced HCC
title_full_unstemmed Effectiveness and tolerability of camrelizumab combined with molecular targeted therapy for patients with unresectable or advanced HCC
title_short Effectiveness and tolerability of camrelizumab combined with molecular targeted therapy for patients with unresectable or advanced HCC
title_sort effectiveness and tolerability of camrelizumab combined with molecular targeted therapy for patients with unresectable or advanced hcc
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10264531/
https://www.ncbi.nlm.nih.gov/pubmed/36840762
http://dx.doi.org/10.1007/s00262-023-03404-8
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