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肝细胞癌中不同器官特异性肿瘤对免疫检查点抑制剂的反应-ag捕鱼平台

文字: 2020-2-29    浏览次数:437    

background and aims
immune checkpoint inhibitors (icis) exhibit significant clinical activity in patients with advanced hepatocellular carcinoma (hcc). this study explored whether tumor response to icis in hcc varies among different organs.

背景与目的

免疫检查点抑制剂(icis)在晚期肝细胞癌(hcc)患者中具有显著的临床活性。本研究探讨了hcc对icis的反应是否因肿瘤器官的不同而异。

 

methods
we reviewed the data of patients with advanced hcc who had received icis. patients with measurable diseases were enrolled. organ-specific response criteria, adapted from recist 1.1 and immune-related recist, were used to evaluate the objective response to icis in tumors located in the liver, lung, lymph node, and other intra-abdominal sites.

方法

我们回顾了接受icis治疗的晚期hcc患者的资料。纳入可进行分析的患者。采用recist 1.1和免疫相关recist的器官特异性反应标准评估位于肝、肺、淋巴结和其他腹腔内的肿瘤对icis的客观反应。

 

results
of the 75 enrolled patients with advanced hcc, 51 and 11 patients had chronic hepatitis b virus and chronic hepatitis c virus infection, respectively. regarding ici treatment, 58, 1, and 16 patients had undergone anti-pd-1/anti-pd-l1 monoclonal antibody (mab) alone, anti-ctla4 mab alone, and anti-pd-1 mab plus anti-ctla4 mab, respectively; 20 and 55 patients had received icis as first-line or ≥second-line therapy. the overall objective response rate (orr) was 28.0%. in total, 58, 34, 19, and 18 patients had measurable hepatic tumors and lung, lymph node, and other intra-abdominal metastases, and the corresponding organ-specific orrs were 22.4, 41.2, 26.3, and 38.9%, respectively. of the 39 patients who had both hepatic and extrahepatic tumors, 12 had disease control in extrahepatic tumors while progressive disease (pd) in hepatic tumors, whereas only 4 exhibited disease control in hepatic tumors while pd in extrahepatic tumors (p = 0.046, mcnemar test). of the 16 patients with only evaluable tumors in the liver and lungs at baseline, 8 had disease control in the lungs while pd in the liver, and none experienced disease control in the liver while pd in the lungs (p = 0.005). 

结果

在75例晚期hcc患者中,51例为慢性乙型肝炎病毒感染,11例为慢性丙型肝病毒感染。ici治疗方面,58例使用单用抗pd-1/抗pd-l1单克隆抗体(mab)、1例使用单用抗ctla4 mab、16例使用抗pd-1 mab联合抗ctla4 mab进行治疗;20例和55例患者分别接受了icis作为一线或二线及以上的治疗。总体客观缓解率(orr)为28.0%。共有58例、34例、19例和18例患者有可测量的肝、肺、淋巴结和其他腹腔内转移肿瘤,相应的器官特异性orrs分别为22.4%、41.2%、26.3%和38.9%。在39例同时患有肝内和肝外肿瘤的患者中,12例患者肝外肿瘤得到控制而肝内肿瘤出现疾病进展(pd),仅有4例患者肝内肿瘤得到控制而肝外肿瘤出现pd(p = 0.046, mcnemar检验)。在16例基线时仅可评估肝、肺肿瘤的患者中,8例患者肺部肿瘤得到控制而肝肿瘤出现pd;无1例患者肝肿瘤得到控制而肺部肿瘤出现pd(p = 0.005)。

 

conclusions
the hepatic tumors of hcc may be less responsive to icis than extrahepatic lesions. lung metastases responded most favorably to icis. the mechanisms underlying this differential response to icis warrant further investigation.

结论

hcc肝内肿瘤对icis的反应可能比肝外病变要弱。肺部转移肿瘤对icis反应最好。对icis的这种反应差异的机制值得进一步去研究。