Cargando…

Safety of PD-1/PD-L1 Inhibitors Combined With Palliative Radiotherapy and Anti-Angiogenic Therapy in Advanced Hepatocellular Carcinoma

BACKGROUND: Previous studies have explored cancer immunotherapy with radiotherapy or anti-angiogenic therapy, but no trials have reported a triple therapy approach. This study aimed to investigate safety and clinical outcome of PD-1/PD-L1 inhibitors combined with palliative radiotherapy and targeted...

Descripción completa

Detalles Bibliográficos
Autores principales: Zhong, Liting, Wu, Dehua, Peng, Weiwei, Sheng, Hailong, Xiao, Yazhi, Zhang, Xuebing, Wang, Yuli
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8170410/
https://www.ncbi.nlm.nih.gov/pubmed/34094988
http://dx.doi.org/10.3389/fonc.2021.686621
_version_ 1783702237732667392
author Zhong, Liting
Wu, Dehua
Peng, Weiwei
Sheng, Hailong
Xiao, Yazhi
Zhang, Xuebing
Wang, Yuli
author_facet Zhong, Liting
Wu, Dehua
Peng, Weiwei
Sheng, Hailong
Xiao, Yazhi
Zhang, Xuebing
Wang, Yuli
author_sort Zhong, Liting
collection PubMed
description BACKGROUND: Previous studies have explored cancer immunotherapy with radiotherapy or anti-angiogenic therapy, but no trials have reported a triple therapy approach. This study aimed to investigate safety and clinical outcome of PD-1/PD-L1 inhibitors combined with palliative radiotherapy and targeted angiogenesis therapy in hepatocellular carcinoma (HCC) of Barcelona Clinic Liver Cancer (BCLC) stage C. METHODS: Consecutive patients (n=16) treated with PD-1/PD-L1 inhibitors combined with radiotherapy and anti-angiogenic therapy in a bi-institutional cohort between July 2017 and December 2020 were retrospectively included. Radiotherapy was conducted within 14 days of the first administration of immunotherapy. The primary endpoint was treatment-related adverse event (TRAE). RESULTS: The median follow-up was 383 days. Fifteen patients (93.8%) experienced at least 1 TRAE. The most common TRAEs of any grade were rash (25%), diarrhea (25%), aspartate aminotransferase increase (18.8%), alanine transaminase increase (18.8%), decreased appetite (18.8%), and fatigue (18.8%). Grade 3/4 TRAEs occurred in 4 patients (25%) and finally led to treatment interruption. No patient death was attributed to treatment. No specific events were responsible for the addition of radiotherapy. Six patients showed partial response, 7 showed stable disease, and 2 showed progressive disease. The objective response rate and disease control rate were 40.0% (95% CI 16.3%–67.7%) and 86.7% (95% CI 59.5%–98.3%), respectively. Moreover, the median progression-free survival was 140 days. Patients had a median overall survival of 637 days, and the estimated rates of survival at 6 and 12 months were 92.3% and 75.5%, respectively. CONCLUSION: PD-1/PD-L1 inhibitors combined with palliative radiotherapy and anti-angiogenic therapy appear to be safe, with no unexpected adverse events. Additional studies exploring the clinical benefit are warranted.
format Online
Article
Text
id pubmed-8170410
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-81704102021-06-03 Safety of PD-1/PD-L1 Inhibitors Combined With Palliative Radiotherapy and Anti-Angiogenic Therapy in Advanced Hepatocellular Carcinoma Zhong, Liting Wu, Dehua Peng, Weiwei Sheng, Hailong Xiao, Yazhi Zhang, Xuebing Wang, Yuli Front Oncol Oncology BACKGROUND: Previous studies have explored cancer immunotherapy with radiotherapy or anti-angiogenic therapy, but no trials have reported a triple therapy approach. This study aimed to investigate safety and clinical outcome of PD-1/PD-L1 inhibitors combined with palliative radiotherapy and targeted angiogenesis therapy in hepatocellular carcinoma (HCC) of Barcelona Clinic Liver Cancer (BCLC) stage C. METHODS: Consecutive patients (n=16) treated with PD-1/PD-L1 inhibitors combined with radiotherapy and anti-angiogenic therapy in a bi-institutional cohort between July 2017 and December 2020 were retrospectively included. Radiotherapy was conducted within 14 days of the first administration of immunotherapy. The primary endpoint was treatment-related adverse event (TRAE). RESULTS: The median follow-up was 383 days. Fifteen patients (93.8%) experienced at least 1 TRAE. The most common TRAEs of any grade were rash (25%), diarrhea (25%), aspartate aminotransferase increase (18.8%), alanine transaminase increase (18.8%), decreased appetite (18.8%), and fatigue (18.8%). Grade 3/4 TRAEs occurred in 4 patients (25%) and finally led to treatment interruption. No patient death was attributed to treatment. No specific events were responsible for the addition of radiotherapy. Six patients showed partial response, 7 showed stable disease, and 2 showed progressive disease. The objective response rate and disease control rate were 40.0% (95% CI 16.3%–67.7%) and 86.7% (95% CI 59.5%–98.3%), respectively. Moreover, the median progression-free survival was 140 days. Patients had a median overall survival of 637 days, and the estimated rates of survival at 6 and 12 months were 92.3% and 75.5%, respectively. CONCLUSION: PD-1/PD-L1 inhibitors combined with palliative radiotherapy and anti-angiogenic therapy appear to be safe, with no unexpected adverse events. Additional studies exploring the clinical benefit are warranted. Frontiers Media S.A. 2021-05-19 /pmc/articles/PMC8170410/ /pubmed/34094988 http://dx.doi.org/10.3389/fonc.2021.686621 Text en Copyright © 2021 Zhong, Wu, Peng, Sheng, Xiao, Zhang and Wang https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Zhong, Liting
Wu, Dehua
Peng, Weiwei
Sheng, Hailong
Xiao, Yazhi
Zhang, Xuebing
Wang, Yuli
Safety of PD-1/PD-L1 Inhibitors Combined With Palliative Radiotherapy and Anti-Angiogenic Therapy in Advanced Hepatocellular Carcinoma
title Safety of PD-1/PD-L1 Inhibitors Combined With Palliative Radiotherapy and Anti-Angiogenic Therapy in Advanced Hepatocellular Carcinoma
title_full Safety of PD-1/PD-L1 Inhibitors Combined With Palliative Radiotherapy and Anti-Angiogenic Therapy in Advanced Hepatocellular Carcinoma
title_fullStr Safety of PD-1/PD-L1 Inhibitors Combined With Palliative Radiotherapy and Anti-Angiogenic Therapy in Advanced Hepatocellular Carcinoma
title_full_unstemmed Safety of PD-1/PD-L1 Inhibitors Combined With Palliative Radiotherapy and Anti-Angiogenic Therapy in Advanced Hepatocellular Carcinoma
title_short Safety of PD-1/PD-L1 Inhibitors Combined With Palliative Radiotherapy and Anti-Angiogenic Therapy in Advanced Hepatocellular Carcinoma
title_sort safety of pd-1/pd-l1 inhibitors combined with palliative radiotherapy and anti-angiogenic therapy in advanced hepatocellular carcinoma
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8170410/
https://www.ncbi.nlm.nih.gov/pubmed/34094988
http://dx.doi.org/10.3389/fonc.2021.686621
work_keys_str_mv AT zhongliting safetyofpd1pdl1inhibitorscombinedwithpalliativeradiotherapyandantiangiogenictherapyinadvancedhepatocellularcarcinoma
AT wudehua safetyofpd1pdl1inhibitorscombinedwithpalliativeradiotherapyandantiangiogenictherapyinadvancedhepatocellularcarcinoma
AT pengweiwei safetyofpd1pdl1inhibitorscombinedwithpalliativeradiotherapyandantiangiogenictherapyinadvancedhepatocellularcarcinoma
AT shenghailong safetyofpd1pdl1inhibitorscombinedwithpalliativeradiotherapyandantiangiogenictherapyinadvancedhepatocellularcarcinoma
AT xiaoyazhi safetyofpd1pdl1inhibitorscombinedwithpalliativeradiotherapyandantiangiogenictherapyinadvancedhepatocellularcarcinoma
AT zhangxuebing safetyofpd1pdl1inhibitorscombinedwithpalliativeradiotherapyandantiangiogenictherapyinadvancedhepatocellularcarcinoma
AT wangyuli safetyofpd1pdl1inhibitorscombinedwithpalliativeradiotherapyandantiangiogenictherapyinadvancedhepatocellularcarcinoma