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A multi-center retrospective study on the efficacy and safety of regorafenib vs. regorafenib combined with PD-1 inhibitors as a second-line therapy in patients with advanced hepatocellular carcinoma

BACKGROUND: At present, there are no definitive optimal treatment options for patients with hepatocellular carcinoma (HCC) following first-line treatment failure. To maximize the survival benefit of patients, we compared the combination therapy of regorafenib and programmed death-1 (PD-1) inhibitors...

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Autores principales: Yan, Tao, Huang, Chenyang, Peng, Caiyun, Duan, Xuezhang, Ji, Dong, Duan, Youjia, Zhang, Wen, Zhao, Haitao, Gao, Kun, Yang, Xiangyu, Zhang, Linzhi, Cheng, Jiamin, de Castria, Tiago Biachi, Pocha, Christine, Tsilimigras, Diamantis I., Wu, Tong, Su, Guodong, Li, Yinyin, Yu, Lingxiang, Lu, Yinying
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9929741/
https://www.ncbi.nlm.nih.gov/pubmed/36819518
http://dx.doi.org/10.21037/atm-22-6614
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author Yan, Tao
Huang, Chenyang
Peng, Caiyun
Duan, Xuezhang
Ji, Dong
Duan, Youjia
Zhang, Wen
Zhao, Haitao
Gao, Kun
Yang, Xiangyu
Zhang, Linzhi
Cheng, Jiamin
de Castria, Tiago Biachi
Pocha, Christine
Tsilimigras, Diamantis I.
Wu, Tong
Su, Guodong
Li, Yinyin
Yu, Lingxiang
Lu, Yinying
author_facet Yan, Tao
Huang, Chenyang
Peng, Caiyun
Duan, Xuezhang
Ji, Dong
Duan, Youjia
Zhang, Wen
Zhao, Haitao
Gao, Kun
Yang, Xiangyu
Zhang, Linzhi
Cheng, Jiamin
de Castria, Tiago Biachi
Pocha, Christine
Tsilimigras, Diamantis I.
Wu, Tong
Su, Guodong
Li, Yinyin
Yu, Lingxiang
Lu, Yinying
author_sort Yan, Tao
collection PubMed
description BACKGROUND: At present, there are no definitive optimal treatment options for patients with hepatocellular carcinoma (HCC) following first-line treatment failure. To maximize the survival benefit of patients, we compared the combination therapy of regorafenib and programmed death-1 (PD-1) inhibitors with regorafenib monotherapy as a second-line treatment for patients with advanced HCC. METHODS: Our multicenter retrospective study evaluated consecutive patients with advanced HCC who received regorafenib plus PD-1 inhibitors or regorafenib alone as a later-line therapy from May 2019 to January 2022. The primary endpoint was progression-free survival (PFS), and the secondary endpoints included the objective response rate (ORR), disease control rate (DCR), overall survival (OS), and safety. Efficacy was evaluated using the Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 criteria, and safety was assessed by Common Terminology Criteria for Adverse Events (CTCAE) v5.0. RESULTS: A total of 133 patients were included in the study (regardless of first-line treatment), including 94 who received regorafenib plus PD-1 inhibitors and 39 who received regorafenib. The regorafenib plus PD-1 inhibitors group had a significantly higher ORR (25.53% vs. 10.26%, P=0.015), higher DCR (87.23% vs. 66.67%, P=0.006), and longer PFS (median 9.0 vs. 4.0 months, P<0.0001) than the regorafenib group. Meanwhile, the median OS (mOS) did not differ between the regorafenib plus PD-1 and regorafenib monotherapy groups {mOS, 14.0 months [95% confidence interval (CI), 14.0–16.0 months] vs. 12.0 months (95% CI, 10.0–22.0 months)}. There was no notable difference in the total incidence of treatment-related adverse effects (TRAEs) (71.79% vs. 78.72%, P=0.39) and the incidence of grade 3/4 serious adverse effects (5.13% vs. 18.09%, P=0.19) between the regorafenib monotherapy group and PD-1 inhibitors combination group. CONCLUSIONS: Compared with regorafenib alone, regorafenib combined with PD-1 inhibitors therapy increased PFS, ORR but did not improve OS, and can be used an option in second-line HCC therapy, regardless of first-line treatments. Regorafenib combined with PD-1 inhibitors is recommended as early as a second-line therapy to benefit patients. The combination regimen was as safe as regorafenib monotherapy for treatment of HCC in patients with compensated liver disease [Child-Turcotte-Pugh (CTP) A/B].
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spelling pubmed-99297412023-02-16 A multi-center retrospective study on the efficacy and safety of regorafenib vs. regorafenib combined with PD-1 inhibitors as a second-line therapy in patients with advanced hepatocellular carcinoma Yan, Tao Huang, Chenyang Peng, Caiyun Duan, Xuezhang Ji, Dong Duan, Youjia Zhang, Wen Zhao, Haitao Gao, Kun Yang, Xiangyu Zhang, Linzhi Cheng, Jiamin de Castria, Tiago Biachi Pocha, Christine Tsilimigras, Diamantis I. Wu, Tong Su, Guodong Li, Yinyin Yu, Lingxiang Lu, Yinying Ann Transl Med Original Article BACKGROUND: At present, there are no definitive optimal treatment options for patients with hepatocellular carcinoma (HCC) following first-line treatment failure. To maximize the survival benefit of patients, we compared the combination therapy of regorafenib and programmed death-1 (PD-1) inhibitors with regorafenib monotherapy as a second-line treatment for patients with advanced HCC. METHODS: Our multicenter retrospective study evaluated consecutive patients with advanced HCC who received regorafenib plus PD-1 inhibitors or regorafenib alone as a later-line therapy from May 2019 to January 2022. The primary endpoint was progression-free survival (PFS), and the secondary endpoints included the objective response rate (ORR), disease control rate (DCR), overall survival (OS), and safety. Efficacy was evaluated using the Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 criteria, and safety was assessed by Common Terminology Criteria for Adverse Events (CTCAE) v5.0. RESULTS: A total of 133 patients were included in the study (regardless of first-line treatment), including 94 who received regorafenib plus PD-1 inhibitors and 39 who received regorafenib. The regorafenib plus PD-1 inhibitors group had a significantly higher ORR (25.53% vs. 10.26%, P=0.015), higher DCR (87.23% vs. 66.67%, P=0.006), and longer PFS (median 9.0 vs. 4.0 months, P<0.0001) than the regorafenib group. Meanwhile, the median OS (mOS) did not differ between the regorafenib plus PD-1 and regorafenib monotherapy groups {mOS, 14.0 months [95% confidence interval (CI), 14.0–16.0 months] vs. 12.0 months (95% CI, 10.0–22.0 months)}. There was no notable difference in the total incidence of treatment-related adverse effects (TRAEs) (71.79% vs. 78.72%, P=0.39) and the incidence of grade 3/4 serious adverse effects (5.13% vs. 18.09%, P=0.19) between the regorafenib monotherapy group and PD-1 inhibitors combination group. CONCLUSIONS: Compared with regorafenib alone, regorafenib combined with PD-1 inhibitors therapy increased PFS, ORR but did not improve OS, and can be used an option in second-line HCC therapy, regardless of first-line treatments. Regorafenib combined with PD-1 inhibitors is recommended as early as a second-line therapy to benefit patients. The combination regimen was as safe as regorafenib monotherapy for treatment of HCC in patients with compensated liver disease [Child-Turcotte-Pugh (CTP) A/B]. AME Publishing Company 2023-01-31 2023-01-31 /pmc/articles/PMC9929741/ /pubmed/36819518 http://dx.doi.org/10.21037/atm-22-6614 Text en 2023 Annals of Translational Medicine. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Yan, Tao
Huang, Chenyang
Peng, Caiyun
Duan, Xuezhang
Ji, Dong
Duan, Youjia
Zhang, Wen
Zhao, Haitao
Gao, Kun
Yang, Xiangyu
Zhang, Linzhi
Cheng, Jiamin
de Castria, Tiago Biachi
Pocha, Christine
Tsilimigras, Diamantis I.
Wu, Tong
Su, Guodong
Li, Yinyin
Yu, Lingxiang
Lu, Yinying
A multi-center retrospective study on the efficacy and safety of regorafenib vs. regorafenib combined with PD-1 inhibitors as a second-line therapy in patients with advanced hepatocellular carcinoma
title A multi-center retrospective study on the efficacy and safety of regorafenib vs. regorafenib combined with PD-1 inhibitors as a second-line therapy in patients with advanced hepatocellular carcinoma
title_full A multi-center retrospective study on the efficacy and safety of regorafenib vs. regorafenib combined with PD-1 inhibitors as a second-line therapy in patients with advanced hepatocellular carcinoma
title_fullStr A multi-center retrospective study on the efficacy and safety of regorafenib vs. regorafenib combined with PD-1 inhibitors as a second-line therapy in patients with advanced hepatocellular carcinoma
title_full_unstemmed A multi-center retrospective study on the efficacy and safety of regorafenib vs. regorafenib combined with PD-1 inhibitors as a second-line therapy in patients with advanced hepatocellular carcinoma
title_short A multi-center retrospective study on the efficacy and safety of regorafenib vs. regorafenib combined with PD-1 inhibitors as a second-line therapy in patients with advanced hepatocellular carcinoma
title_sort multi-center retrospective study on the efficacy and safety of regorafenib vs. regorafenib combined with pd-1 inhibitors as a second-line therapy in patients with advanced hepatocellular carcinoma
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9929741/
https://www.ncbi.nlm.nih.gov/pubmed/36819518
http://dx.doi.org/10.21037/atm-22-6614
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