Combined radiation and immune checkpoint inhibitor therapy for metastatic or recurrent hepatocellular carcinoma: a real-world study of 108 patients
BackgroundThe prognosis of metastatic or recurrent hepatocellular carcinoma (HCC) remains poor, and new treatment strategies are warranted. Despite promising preclinical results demonstrating that radiation primes the immune system and produces a synergistic antitumor response for long-term disease...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-08-01
|
| Series: | Frontiers in Immunology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1594577/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850026805582364672 |
|---|---|
| author | Yirui Zhai Yefan Zhang Fan Wu Jianguo Zhou Lingxia Xin Feng Ye Wei Sun Huiying Zeng Yan Song Yongkun Sun Wen Zhang Shu-Lian Wang Yuan Tang Hui Fang Pan Zhao Yueping Liu Ningning Lu Shunan Qi Hao Jing Wenwen Zhang Yongwen Song Ye-Xiong Li Liming Wang Bo Chen |
| author_facet | Yirui Zhai Yefan Zhang Fan Wu Jianguo Zhou Lingxia Xin Feng Ye Wei Sun Huiying Zeng Yan Song Yongkun Sun Wen Zhang Shu-Lian Wang Yuan Tang Hui Fang Pan Zhao Yueping Liu Ningning Lu Shunan Qi Hao Jing Wenwen Zhang Yongwen Song Ye-Xiong Li Liming Wang Bo Chen |
| author_sort | Yirui Zhai |
| collection | DOAJ |
| description | BackgroundThe prognosis of metastatic or recurrent hepatocellular carcinoma (HCC) remains poor, and new treatment strategies are warranted. Despite promising preclinical results demonstrating that radiation primes the immune system and produces a synergistic antitumor response for long-term disease control, limited clinical data are available. Therefore, in this study, we investigated the efficacy and safety of combining radiotherapy with immune checkpoint inhibitors (ICIs) for patients with metastatic and recurrent HCC in a real-world setting.Materials and methodsPatients with stage IV or recurrent HCC who received sequential or concurrent radiotherapy and ICIs in our institution were enrolled in this study. Data regarding clinicopathological characteristics, treatment protocols, response rates, toxicities, and survival were collected.ResultsFrom January 2018 to December 2021, 108 patients were included. Extra-hepatic metastasis and portal vein tumor thrombosis were recorded in 58 (53.7%) and 69 patients (63.9%), respectively. A median radiation dose of 55 Gy was administered, and ICIs were administered for 3 weeks until disease progression or limiting toxicities occurred. After treatment, the overall response rate was 75.0%, and the median follow-up duration was 18.8 months. Median overall survival and progression-free survival were 17.0 and 12.6 months, respectively. Only one patient experienced in-field recurrence. Grade ≥3 adverse events were observed in 30.6% of patients. Dermatitis was the most common toxicity-related event and thrombocytopenia was the most common grade ≥3 adverse event, occurring overall in 17.6% of patients.ConclusionThe ICI and radiotherapy combination was effective and well-tolerated in real-world patients, achieving more favorable results compared with historical ones and providing a new multimodality therapy for patients with recurrent and metastatic HCC. |
| format | Article |
| id | doaj-art-8645d12a4c4e4d949f17f0a49b41129b |
| institution | DOAJ |
| issn | 1664-3224 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj-art-8645d12a4c4e4d949f17f0a49b41129b2025-08-20T03:00:25ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-08-011610.3389/fimmu.2025.15945771594577Combined radiation and immune checkpoint inhibitor therapy for metastatic or recurrent hepatocellular carcinoma: a real-world study of 108 patientsYirui Zhai0Yefan Zhang1Fan Wu2Jianguo Zhou3Lingxia Xin4Feng Ye5Wei Sun6Huiying Zeng7Yan Song8Yongkun Sun9Wen Zhang10Shu-Lian Wang11Yuan Tang12Hui Fang13Pan Zhao14Yueping Liu15Ningning Lu16Shunan Qi17Hao Jing18Wenwen Zhang19Yongwen Song20Ye-Xiong Li21Liming Wang22Bo Chen23Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaBackgroundThe prognosis of metastatic or recurrent hepatocellular carcinoma (HCC) remains poor, and new treatment strategies are warranted. Despite promising preclinical results demonstrating that radiation primes the immune system and produces a synergistic antitumor response for long-term disease control, limited clinical data are available. Therefore, in this study, we investigated the efficacy and safety of combining radiotherapy with immune checkpoint inhibitors (ICIs) for patients with metastatic and recurrent HCC in a real-world setting.Materials and methodsPatients with stage IV or recurrent HCC who received sequential or concurrent radiotherapy and ICIs in our institution were enrolled in this study. Data regarding clinicopathological characteristics, treatment protocols, response rates, toxicities, and survival were collected.ResultsFrom January 2018 to December 2021, 108 patients were included. Extra-hepatic metastasis and portal vein tumor thrombosis were recorded in 58 (53.7%) and 69 patients (63.9%), respectively. A median radiation dose of 55 Gy was administered, and ICIs were administered for 3 weeks until disease progression or limiting toxicities occurred. After treatment, the overall response rate was 75.0%, and the median follow-up duration was 18.8 months. Median overall survival and progression-free survival were 17.0 and 12.6 months, respectively. Only one patient experienced in-field recurrence. Grade ≥3 adverse events were observed in 30.6% of patients. Dermatitis was the most common toxicity-related event and thrombocytopenia was the most common grade ≥3 adverse event, occurring overall in 17.6% of patients.ConclusionThe ICI and radiotherapy combination was effective and well-tolerated in real-world patients, achieving more favorable results compared with historical ones and providing a new multimodality therapy for patients with recurrent and metastatic HCC.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1594577/fullhepatocellular carcinomaradiotherapyimmunotherapyimmune checkpoint inhibitorPD-1/PD-L1 inhibitor |
| spellingShingle | Yirui Zhai Yefan Zhang Fan Wu Jianguo Zhou Lingxia Xin Feng Ye Wei Sun Huiying Zeng Yan Song Yongkun Sun Wen Zhang Shu-Lian Wang Yuan Tang Hui Fang Pan Zhao Yueping Liu Ningning Lu Shunan Qi Hao Jing Wenwen Zhang Yongwen Song Ye-Xiong Li Liming Wang Bo Chen Combined radiation and immune checkpoint inhibitor therapy for metastatic or recurrent hepatocellular carcinoma: a real-world study of 108 patients Frontiers in Immunology hepatocellular carcinoma radiotherapy immunotherapy immune checkpoint inhibitor PD-1/PD-L1 inhibitor |
| title | Combined radiation and immune checkpoint inhibitor therapy for metastatic or recurrent hepatocellular carcinoma: a real-world study of 108 patients |
| title_full | Combined radiation and immune checkpoint inhibitor therapy for metastatic or recurrent hepatocellular carcinoma: a real-world study of 108 patients |
| title_fullStr | Combined radiation and immune checkpoint inhibitor therapy for metastatic or recurrent hepatocellular carcinoma: a real-world study of 108 patients |
| title_full_unstemmed | Combined radiation and immune checkpoint inhibitor therapy for metastatic or recurrent hepatocellular carcinoma: a real-world study of 108 patients |
| title_short | Combined radiation and immune checkpoint inhibitor therapy for metastatic or recurrent hepatocellular carcinoma: a real-world study of 108 patients |
| title_sort | combined radiation and immune checkpoint inhibitor therapy for metastatic or recurrent hepatocellular carcinoma a real world study of 108 patients |
| topic | hepatocellular carcinoma radiotherapy immunotherapy immune checkpoint inhibitor PD-1/PD-L1 inhibitor |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1594577/full |
| work_keys_str_mv | AT yiruizhai combinedradiationandimmunecheckpointinhibitortherapyformetastaticorrecurrenthepatocellularcarcinomaarealworldstudyof108patients AT yefanzhang combinedradiationandimmunecheckpointinhibitortherapyformetastaticorrecurrenthepatocellularcarcinomaarealworldstudyof108patients AT fanwu combinedradiationandimmunecheckpointinhibitortherapyformetastaticorrecurrenthepatocellularcarcinomaarealworldstudyof108patients AT jianguozhou combinedradiationandimmunecheckpointinhibitortherapyformetastaticorrecurrenthepatocellularcarcinomaarealworldstudyof108patients AT lingxiaxin combinedradiationandimmunecheckpointinhibitortherapyformetastaticorrecurrenthepatocellularcarcinomaarealworldstudyof108patients AT fengye combinedradiationandimmunecheckpointinhibitortherapyformetastaticorrecurrenthepatocellularcarcinomaarealworldstudyof108patients AT weisun combinedradiationandimmunecheckpointinhibitortherapyformetastaticorrecurrenthepatocellularcarcinomaarealworldstudyof108patients AT huiyingzeng combinedradiationandimmunecheckpointinhibitortherapyformetastaticorrecurrenthepatocellularcarcinomaarealworldstudyof108patients AT yansong combinedradiationandimmunecheckpointinhibitortherapyformetastaticorrecurrenthepatocellularcarcinomaarealworldstudyof108patients AT yongkunsun combinedradiationandimmunecheckpointinhibitortherapyformetastaticorrecurrenthepatocellularcarcinomaarealworldstudyof108patients AT wenzhang combinedradiationandimmunecheckpointinhibitortherapyformetastaticorrecurrenthepatocellularcarcinomaarealworldstudyof108patients AT shulianwang combinedradiationandimmunecheckpointinhibitortherapyformetastaticorrecurrenthepatocellularcarcinomaarealworldstudyof108patients AT yuantang combinedradiationandimmunecheckpointinhibitortherapyformetastaticorrecurrenthepatocellularcarcinomaarealworldstudyof108patients AT huifang combinedradiationandimmunecheckpointinhibitortherapyformetastaticorrecurrenthepatocellularcarcinomaarealworldstudyof108patients AT panzhao combinedradiationandimmunecheckpointinhibitortherapyformetastaticorrecurrenthepatocellularcarcinomaarealworldstudyof108patients AT yuepingliu combinedradiationandimmunecheckpointinhibitortherapyformetastaticorrecurrenthepatocellularcarcinomaarealworldstudyof108patients AT ningninglu combinedradiationandimmunecheckpointinhibitortherapyformetastaticorrecurrenthepatocellularcarcinomaarealworldstudyof108patients AT shunanqi combinedradiationandimmunecheckpointinhibitortherapyformetastaticorrecurrenthepatocellularcarcinomaarealworldstudyof108patients AT haojing combinedradiationandimmunecheckpointinhibitortherapyformetastaticorrecurrenthepatocellularcarcinomaarealworldstudyof108patients AT wenwenzhang combinedradiationandimmunecheckpointinhibitortherapyformetastaticorrecurrenthepatocellularcarcinomaarealworldstudyof108patients AT yongwensong combinedradiationandimmunecheckpointinhibitortherapyformetastaticorrecurrenthepatocellularcarcinomaarealworldstudyof108patients AT yexiongli combinedradiationandimmunecheckpointinhibitortherapyformetastaticorrecurrenthepatocellularcarcinomaarealworldstudyof108patients AT limingwang combinedradiationandimmunecheckpointinhibitortherapyformetastaticorrecurrenthepatocellularcarcinomaarealworldstudyof108patients AT bochen combinedradiationandimmunecheckpointinhibitortherapyformetastaticorrecurrenthepatocellularcarcinomaarealworldstudyof108patients |