Comparing PD-L1 with PD-1 antibodies combined with lenvatinib and hepatic arterial infusion chemotherapy for unresectable hepatocellular carcinoma

BackgroundA combination of hepatic arterial infusion chemotherapy (HAIC), lenvatinib, and immune checkpoint inhibitors (ICIs) yields a high tumor response rate and survival benefit in unresectable hepatocellular carcinoma (uHCC). However, the selection criteria for different ICIs remain unclear. Thi...

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Main Authors: Shaohua Li, Jie Mei, Rongce Zhao, Jing Zhou, Qiaoxuan Wang, Lianghe Lu, Jibin Li, Lie Zheng, Wei Wei, Rongping Guo
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-10-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2024.1491857/full
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author Shaohua Li
Shaohua Li
Jie Mei
Jie Mei
Rongce Zhao
Rongce Zhao
Jing Zhou
Jing Zhou
Qiaoxuan Wang
Qiaoxuan Wang
Lianghe Lu
Lianghe Lu
Jibin Li
Jibin Li
Lie Zheng
Lie Zheng
Wei Wei
Wei Wei
Rongping Guo
Rongping Guo
author_facet Shaohua Li
Shaohua Li
Jie Mei
Jie Mei
Rongce Zhao
Rongce Zhao
Jing Zhou
Jing Zhou
Qiaoxuan Wang
Qiaoxuan Wang
Lianghe Lu
Lianghe Lu
Jibin Li
Jibin Li
Lie Zheng
Lie Zheng
Wei Wei
Wei Wei
Rongping Guo
Rongping Guo
author_sort Shaohua Li
collection DOAJ
description BackgroundA combination of hepatic arterial infusion chemotherapy (HAIC), lenvatinib, and immune checkpoint inhibitors (ICIs) yields a high tumor response rate and survival benefit in unresectable hepatocellular carcinoma (uHCC). However, the selection criteria for different ICIs remain unclear. This study aims to compare the efficacy and safety of PD-1/PD-L1 antibodies combined with HAIC and lenvatinib.MethodsThis retrospective study included 184 patients with uHCC treated with HAIC+lenvatinib+PD-1/PD-L1 antibody from June 2019 to January 2022. We utilized propensity score matching (PSM) to select and match 60 patients treated with HAIC + durvalumab + lenvatinib (HDL) against 60 patients treated with HAIC + PD-1 antibodies + lenvatinib (HPL) to compare the efficacy and safety profiles of these two groups.ResultsAfter PSM, the baseline characteristics were well-balanced between the HDL and HPL groups. The overall survival (p = 0.293) and progression-free survival (p = 0.146) showed no significant difference. The objective response rate (ORR) was higher in the HDL group compared to the HPL group according to modified RECIST (74.1% vs. 53.6%, p = 0.022) and RECIST 1.1 (60.3% vs. 41.1%, p = 0.040), respectively. The incidence of grade 3 or 4 adverse events (AEs) was 10.0% and 18.3% (p = 0.191) in the HDL and HPL groups, respectively.ConclusionsPD-L1 antibody appears to be a preferable companion in the combination therapy of HAIC + ICIs + lenvatinib compared to PD-1 antibody, showing higher ORR and relatively lower incidence of severe AEs. Further prospective studies involving a larger patient population are warranted.
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spelling doaj-art-5cb8f662cec44405bc4bc6946486ad9c2025-08-20T02:09:48ZengFrontiers Media S.A.Frontiers in Immunology1664-32242024-10-011510.3389/fimmu.2024.14918571491857Comparing PD-L1 with PD-1 antibodies combined with lenvatinib and hepatic arterial infusion chemotherapy for unresectable hepatocellular carcinomaShaohua Li0Shaohua Li1Jie Mei2Jie Mei3Rongce Zhao4Rongce Zhao5Jing Zhou6Jing Zhou7Qiaoxuan Wang8Qiaoxuan Wang9Lianghe Lu10Lianghe Lu11Jibin Li12Jibin Li13Lie Zheng14Lie Zheng15Wei Wei16Wei Wei17Rongping Guo18Rongping Guo19Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, ChinaState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, ChinaDepartment of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, ChinaState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, ChinaDepartment of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, ChinaState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, ChinaState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, ChinaDepartment of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, ChinaState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, ChinaDepartment of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, ChinaDepartment of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, ChinaState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, ChinaState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, ChinaDepartment of Clinical Research Methodology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, ChinaState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, ChinaDepartment of Radiology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, ChinaDepartment of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, ChinaState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, ChinaDepartment of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, ChinaState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, ChinaBackgroundA combination of hepatic arterial infusion chemotherapy (HAIC), lenvatinib, and immune checkpoint inhibitors (ICIs) yields a high tumor response rate and survival benefit in unresectable hepatocellular carcinoma (uHCC). However, the selection criteria for different ICIs remain unclear. This study aims to compare the efficacy and safety of PD-1/PD-L1 antibodies combined with HAIC and lenvatinib.MethodsThis retrospective study included 184 patients with uHCC treated with HAIC+lenvatinib+PD-1/PD-L1 antibody from June 2019 to January 2022. We utilized propensity score matching (PSM) to select and match 60 patients treated with HAIC + durvalumab + lenvatinib (HDL) against 60 patients treated with HAIC + PD-1 antibodies + lenvatinib (HPL) to compare the efficacy and safety profiles of these two groups.ResultsAfter PSM, the baseline characteristics were well-balanced between the HDL and HPL groups. The overall survival (p = 0.293) and progression-free survival (p = 0.146) showed no significant difference. The objective response rate (ORR) was higher in the HDL group compared to the HPL group according to modified RECIST (74.1% vs. 53.6%, p = 0.022) and RECIST 1.1 (60.3% vs. 41.1%, p = 0.040), respectively. The incidence of grade 3 or 4 adverse events (AEs) was 10.0% and 18.3% (p = 0.191) in the HDL and HPL groups, respectively.ConclusionsPD-L1 antibody appears to be a preferable companion in the combination therapy of HAIC + ICIs + lenvatinib compared to PD-1 antibody, showing higher ORR and relatively lower incidence of severe AEs. Further prospective studies involving a larger patient population are warranted.https://www.frontiersin.org/articles/10.3389/fimmu.2024.1491857/fullhepatocellular carcinomaPD-1/PD-L1 antibodieshepatic arterial infusion chemotherapylenvatinibdurvalumabcombination therapy
spellingShingle Shaohua Li
Shaohua Li
Jie Mei
Jie Mei
Rongce Zhao
Rongce Zhao
Jing Zhou
Jing Zhou
Qiaoxuan Wang
Qiaoxuan Wang
Lianghe Lu
Lianghe Lu
Jibin Li
Jibin Li
Lie Zheng
Lie Zheng
Wei Wei
Wei Wei
Rongping Guo
Rongping Guo
Comparing PD-L1 with PD-1 antibodies combined with lenvatinib and hepatic arterial infusion chemotherapy for unresectable hepatocellular carcinoma
Frontiers in Immunology
hepatocellular carcinoma
PD-1/PD-L1 antibodies
hepatic arterial infusion chemotherapy
lenvatinib
durvalumab
combination therapy
title Comparing PD-L1 with PD-1 antibodies combined with lenvatinib and hepatic arterial infusion chemotherapy for unresectable hepatocellular carcinoma
title_full Comparing PD-L1 with PD-1 antibodies combined with lenvatinib and hepatic arterial infusion chemotherapy for unresectable hepatocellular carcinoma
title_fullStr Comparing PD-L1 with PD-1 antibodies combined with lenvatinib and hepatic arterial infusion chemotherapy for unresectable hepatocellular carcinoma
title_full_unstemmed Comparing PD-L1 with PD-1 antibodies combined with lenvatinib and hepatic arterial infusion chemotherapy for unresectable hepatocellular carcinoma
title_short Comparing PD-L1 with PD-1 antibodies combined with lenvatinib and hepatic arterial infusion chemotherapy for unresectable hepatocellular carcinoma
title_sort comparing pd l1 with pd 1 antibodies combined with lenvatinib and hepatic arterial infusion chemotherapy for unresectable hepatocellular carcinoma
topic hepatocellular carcinoma
PD-1/PD-L1 antibodies
hepatic arterial infusion chemotherapy
lenvatinib
durvalumab
combination therapy
url https://www.frontiersin.org/articles/10.3389/fimmu.2024.1491857/full
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