Comparison of lenvatinib plus pembrolizumab versus first-line systemic chemotherapy for advanced intrahepatic cholangiocarcinoma: a real-world retrospective study
BackgroundSystemic chemotherapy (SC) stands the only first-line treatment for advanced intrahepatic cholangiocarcinoma (iCCA) for the past few decades. Immune checkpoint inhibitors (ICIs) have been proved to provide additional benefit in disease control. However, oncological outcome of iCCA remains...
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Frontiers Media S.A.
2024-11-01
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| author | Zhenyun Yang Zhenyun Yang Zhenyun Yang Weijie Wu Weijie Wu Weijie Wu Zhiwen Hu Zhiwen Hu Zhiwen Hu Yizhen Fu Yizhen Fu Yizhen Fu Zili Hu Zili Hu Zili Hu Yangxun Pan Yangxun Pan Yangxun Pan Juncheng Wang Juncheng Wang Juncheng Wang Jinbin Chen Jinbin Chen Jinbin Chen Zhongguo Zhou Zhongguo Zhou Zhongguo Zhou Yaojun Zhang Yaojun Zhang Yaojun Zhang Minshan Chen Minshan Chen Minshan Chen Dandan Hu Dandan Hu Dandan Hu |
| author_facet | Zhenyun Yang Zhenyun Yang Zhenyun Yang Weijie Wu Weijie Wu Weijie Wu Zhiwen Hu Zhiwen Hu Zhiwen Hu Yizhen Fu Yizhen Fu Yizhen Fu Zili Hu Zili Hu Zili Hu Yangxun Pan Yangxun Pan Yangxun Pan Juncheng Wang Juncheng Wang Juncheng Wang Jinbin Chen Jinbin Chen Jinbin Chen Zhongguo Zhou Zhongguo Zhou Zhongguo Zhou Yaojun Zhang Yaojun Zhang Yaojun Zhang Minshan Chen Minshan Chen Minshan Chen Dandan Hu Dandan Hu Dandan Hu |
| author_sort | Zhenyun Yang |
| collection | DOAJ |
| description | BackgroundSystemic chemotherapy (SC) stands the only first-line treatment for advanced intrahepatic cholangiocarcinoma (iCCA) for the past few decades. Immune checkpoint inhibitors (ICIs) have been proved to provide additional benefit in disease control. However, oncological outcome of iCCA remains poor and awaits further improvement with new treatment modalities. Promising results have been observed in lenvatinib plus pembrolizumab (Len-P) as a second-line therapy in iCCA. This study aimed to explore the safety and efficacy of Len-P as a first-line therapy for iCCA patients in real-world clinical practice.MethodsWe retrospectively enrolled 133 patients with advanced iCCA who received Len-P or SC between May 2019 and May 2023. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and adverse events (AEs) were compared between the two groups.ResultsThere were 72 patients and 61 patients in the Len-P and SC groups, respectively. The median OS for the Len-P and SC groups was 16.3 and 17.8 months, respectively. The median PFS for the Len-P and SC groups was 8.9 and 11.4 months, respectively. There was no significant difference in ORR and DCR between the Len-P and SC groups (ORR: 22.2% vs. 23%; P=0.92; DCR: 69.4% vs. 77%; P=0.58). Additionally, the overall incidence of AEs was lower in the Len-P group than SC group. Low inflammation-based scores were indicative of favorable outcomes in patients undergoing Len-P therapy.ConclusionThis study demonstrated that Len-P is promising for the treatment of advanced ICC, with highly improved safety. It emerges as a viable treatment alternative for advanced iCCA. Inflammation-based scores show potential utility in identifying individuals likely to benefit from Len-P therapy. |
| format | Article |
| id | doaj-art-2b5d1b9bb0da4e6b95721abc94fca174 |
| institution | DOAJ |
| issn | 1664-3224 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Immunology |
| spelling | doaj-art-2b5d1b9bb0da4e6b95721abc94fca1742025-08-20T02:48:57ZengFrontiers Media S.A.Frontiers in Immunology1664-32242024-11-011510.3389/fimmu.2024.14945201494520Comparison of lenvatinib plus pembrolizumab versus first-line systemic chemotherapy for advanced intrahepatic cholangiocarcinoma: a real-world retrospective studyZhenyun Yang0Zhenyun Yang1Zhenyun Yang2Weijie Wu3Weijie Wu4Weijie Wu5Zhiwen Hu6Zhiwen Hu7Zhiwen Hu8Yizhen Fu9Yizhen Fu10Yizhen Fu11Zili Hu12Zili Hu13Zili Hu14Yangxun Pan15Yangxun Pan16Yangxun Pan17Juncheng Wang18Juncheng Wang19Juncheng Wang20Jinbin Chen21Jinbin Chen22Jinbin Chen23Zhongguo Zhou24Zhongguo Zhou25Zhongguo Zhou26Yaojun Zhang27Yaojun Zhang28Yaojun Zhang29Minshan Chen30Minshan Chen31Minshan Chen32Dandan Hu33Dandan Hu34Dandan Hu35Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, ChinaCollaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaGuangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaDepartment of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, ChinaCollaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaGuangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaDepartment of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, ChinaCollaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaGuangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaDepartment of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, ChinaCollaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaGuangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaDepartment of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, ChinaCollaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaGuangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaDepartment of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, ChinaCollaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaGuangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaDepartment of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, ChinaCollaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaGuangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaDepartment of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, ChinaCollaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaGuangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaDepartment of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, ChinaCollaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaGuangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaDepartment of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, ChinaCollaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaGuangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaDepartment of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, ChinaCollaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaGuangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaDepartment of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, ChinaCollaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaGuangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaBackgroundSystemic chemotherapy (SC) stands the only first-line treatment for advanced intrahepatic cholangiocarcinoma (iCCA) for the past few decades. Immune checkpoint inhibitors (ICIs) have been proved to provide additional benefit in disease control. However, oncological outcome of iCCA remains poor and awaits further improvement with new treatment modalities. Promising results have been observed in lenvatinib plus pembrolizumab (Len-P) as a second-line therapy in iCCA. This study aimed to explore the safety and efficacy of Len-P as a first-line therapy for iCCA patients in real-world clinical practice.MethodsWe retrospectively enrolled 133 patients with advanced iCCA who received Len-P or SC between May 2019 and May 2023. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and adverse events (AEs) were compared between the two groups.ResultsThere were 72 patients and 61 patients in the Len-P and SC groups, respectively. The median OS for the Len-P and SC groups was 16.3 and 17.8 months, respectively. The median PFS for the Len-P and SC groups was 8.9 and 11.4 months, respectively. There was no significant difference in ORR and DCR between the Len-P and SC groups (ORR: 22.2% vs. 23%; P=0.92; DCR: 69.4% vs. 77%; P=0.58). Additionally, the overall incidence of AEs was lower in the Len-P group than SC group. Low inflammation-based scores were indicative of favorable outcomes in patients undergoing Len-P therapy.ConclusionThis study demonstrated that Len-P is promising for the treatment of advanced ICC, with highly improved safety. It emerges as a viable treatment alternative for advanced iCCA. Inflammation-based scores show potential utility in identifying individuals likely to benefit from Len-P therapy.https://www.frontiersin.org/articles/10.3389/fimmu.2024.1494520/fullintrahepatic cholangiocarcinomalenvatinibpembrolizumabsystemic chemotherapysurvivaladverse events |
| spellingShingle | Zhenyun Yang Zhenyun Yang Zhenyun Yang Weijie Wu Weijie Wu Weijie Wu Zhiwen Hu Zhiwen Hu Zhiwen Hu Yizhen Fu Yizhen Fu Yizhen Fu Zili Hu Zili Hu Zili Hu Yangxun Pan Yangxun Pan Yangxun Pan Juncheng Wang Juncheng Wang Juncheng Wang Jinbin Chen Jinbin Chen Jinbin Chen Zhongguo Zhou Zhongguo Zhou Zhongguo Zhou Yaojun Zhang Yaojun Zhang Yaojun Zhang Minshan Chen Minshan Chen Minshan Chen Dandan Hu Dandan Hu Dandan Hu Comparison of lenvatinib plus pembrolizumab versus first-line systemic chemotherapy for advanced intrahepatic cholangiocarcinoma: a real-world retrospective study Frontiers in Immunology intrahepatic cholangiocarcinoma lenvatinib pembrolizumab systemic chemotherapy survival adverse events |
| title | Comparison of lenvatinib plus pembrolizumab versus first-line systemic chemotherapy for advanced intrahepatic cholangiocarcinoma: a real-world retrospective study |
| title_full | Comparison of lenvatinib plus pembrolizumab versus first-line systemic chemotherapy for advanced intrahepatic cholangiocarcinoma: a real-world retrospective study |
| title_fullStr | Comparison of lenvatinib plus pembrolizumab versus first-line systemic chemotherapy for advanced intrahepatic cholangiocarcinoma: a real-world retrospective study |
| title_full_unstemmed | Comparison of lenvatinib plus pembrolizumab versus first-line systemic chemotherapy for advanced intrahepatic cholangiocarcinoma: a real-world retrospective study |
| title_short | Comparison of lenvatinib plus pembrolizumab versus first-line systemic chemotherapy for advanced intrahepatic cholangiocarcinoma: a real-world retrospective study |
| title_sort | comparison of lenvatinib plus pembrolizumab versus first line systemic chemotherapy for advanced intrahepatic cholangiocarcinoma a real world retrospective study |
| topic | intrahepatic cholangiocarcinoma lenvatinib pembrolizumab systemic chemotherapy survival adverse events |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1494520/full |
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