Patients with uHCC and Child-Pugh B8/9 also benefit from a combination of antiangiogenic agents and PD-1 inhibitors: a multicenter real-world study
Background and purpose: Patients with unresectable hepatocellular carcinoma (uHCC) and Child-Pugh grade B face limited treatment options and poor outcomes. This study aims to evaluate whether the effect and safety of combining tyrosine kinase inhibitors (TKIs) with progressive disease (PD)-1 inhibit...
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| Language: | English |
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Medical Journals Sweden
2025-05-01
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| Series: | Acta Oncologica |
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| Online Access: | https://medicaljournalssweden.se/actaoncologica/article/view/42652 |
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| author | Xiaoyan Ding Xue Yin Linlin Zheng Lin Zhou Junke Hu Wei Sun Lei Sun Yanjun Shen Ying Teng Yawen Xu Wendong Li Mei Liu Jinglong Chen |
| author_facet | Xiaoyan Ding Xue Yin Linlin Zheng Lin Zhou Junke Hu Wei Sun Lei Sun Yanjun Shen Ying Teng Yawen Xu Wendong Li Mei Liu Jinglong Chen |
| author_sort | Xiaoyan Ding |
| collection | DOAJ |
| description | Background and purpose: Patients with unresectable hepatocellular carcinoma (uHCC) and Child-Pugh grade B face limited treatment options and poor outcomes. This study aims to evaluate whether the effect and safety of combining tyrosine kinase inhibitors (TKIs) with progressive disease (PD)-1 inhibitors in uHCC patients with Child-Pugh B7 (CP7) and B8/9 (CP8/9) differ.
Methods: This multicenter retrospective study included 179 uHCC patients with Child-Pugh B (CP7 group: n = 106; CP8/9 group: n = 73), receiving a combination of lenvatinib/sorafenib/other TKIs and PD-1 inhibitors between December 2020 and March 2023. Progression-free survival (PFS) and overall survival (OS) were defined as the primary endpoint. Secondary endpoints included the objective response rate (ORR) and safety.
Results: The median PFS and OS for the entire cohort were 7.3 months (95% confidence intervals [CI]: 6.3–8.3) and 16.0 months (95% CI: 12.9–19.1), respectively. No statistically significant differences were observed between CP7 and CP8/9 groups in PFS (7.8 vs. 6.3 months, p = 0.28), OS (17.8 vs. 14.0 months, p = 0.20), ORR (33.0% vs. 27.4%, p = 0.42), or safety profiles. However, the CP8/9 group had significantly higher rates of TKI dose reductions (46.6% vs. 31.1%, p = 0.04) and discontinuations (57.5% vs. 24.5%, p < 0.001). Notably, 30.2% of patients maintained sustained radiographic responses despite advanced liver dysfunction.
Interpretation: Combining TKIs with PD-1 inhibitors is an effective and well-tolerated option for HCC patients with Child-Pugh B, including those with CP8/9.
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| format | Article |
| id | doaj-art-de8b0e5e68574038aee265d45f75eef3 |
| institution | OA Journals |
| issn | 1651-226X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Oncologica |
| spelling | doaj-art-de8b0e5e68574038aee265d45f75eef32025-08-20T02:11:26ZengMedical Journals SwedenActa Oncologica1651-226X2025-05-016410.2340/1651-226X.2025.42652Patients with uHCC and Child-Pugh B8/9 also benefit from a combination of antiangiogenic agents and PD-1 inhibitors: a multicenter real-world studyXiaoyan Ding0Xue Yin1Linlin Zheng2Lin Zhou3Junke Hu4Wei Sun5Lei Sun6Yanjun Shen7Ying Teng8Yawen Xu9Wendong Li10Mei Liu11Jinglong Chen12Department of Cancer Center, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaDepartment of Cancer Center, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaJinan Eco-environmental Monitoring Center of Shandong Province, Jinan, Shandong Province, ChinaDepartment of Interventional Radiology, The Fifth Medical Center, Chinese PLA General Hospital, Beijing, ChinaDepartment of Pathology, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaDepartment of Cancer Center, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaDepartment of Pathology, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaDepartment of Cancer Center, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaDepartment of Cancer Center, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaDepartment of Cancer Center, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaDepartment of Cancer Center, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaDepartment of Oncology, Beijing You’an Hospital, Capital Medical University, Beijing, ChinaDepartment of Cancer Center, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaBackground and purpose: Patients with unresectable hepatocellular carcinoma (uHCC) and Child-Pugh grade B face limited treatment options and poor outcomes. This study aims to evaluate whether the effect and safety of combining tyrosine kinase inhibitors (TKIs) with progressive disease (PD)-1 inhibitors in uHCC patients with Child-Pugh B7 (CP7) and B8/9 (CP8/9) differ. Methods: This multicenter retrospective study included 179 uHCC patients with Child-Pugh B (CP7 group: n = 106; CP8/9 group: n = 73), receiving a combination of lenvatinib/sorafenib/other TKIs and PD-1 inhibitors between December 2020 and March 2023. Progression-free survival (PFS) and overall survival (OS) were defined as the primary endpoint. Secondary endpoints included the objective response rate (ORR) and safety. Results: The median PFS and OS for the entire cohort were 7.3 months (95% confidence intervals [CI]: 6.3–8.3) and 16.0 months (95% CI: 12.9–19.1), respectively. No statistically significant differences were observed between CP7 and CP8/9 groups in PFS (7.8 vs. 6.3 months, p = 0.28), OS (17.8 vs. 14.0 months, p = 0.20), ORR (33.0% vs. 27.4%, p = 0.42), or safety profiles. However, the CP8/9 group had significantly higher rates of TKI dose reductions (46.6% vs. 31.1%, p = 0.04) and discontinuations (57.5% vs. 24.5%, p < 0.001). Notably, 30.2% of patients maintained sustained radiographic responses despite advanced liver dysfunction. Interpretation: Combining TKIs with PD-1 inhibitors is an effective and well-tolerated option for HCC patients with Child-Pugh B, including those with CP8/9. https://medicaljournalssweden.se/actaoncologica/article/view/42652Hepatocellular CarcinomaLenvatinibSorafenibImmune Checkpoint InhibitorsChild-Pugh B |
| spellingShingle | Xiaoyan Ding Xue Yin Linlin Zheng Lin Zhou Junke Hu Wei Sun Lei Sun Yanjun Shen Ying Teng Yawen Xu Wendong Li Mei Liu Jinglong Chen Patients with uHCC and Child-Pugh B8/9 also benefit from a combination of antiangiogenic agents and PD-1 inhibitors: a multicenter real-world study Acta Oncologica Hepatocellular Carcinoma Lenvatinib Sorafenib Immune Checkpoint Inhibitors Child-Pugh B |
| title | Patients with uHCC and Child-Pugh B8/9 also benefit from a combination of antiangiogenic agents and PD-1 inhibitors: a multicenter real-world study |
| title_full | Patients with uHCC and Child-Pugh B8/9 also benefit from a combination of antiangiogenic agents and PD-1 inhibitors: a multicenter real-world study |
| title_fullStr | Patients with uHCC and Child-Pugh B8/9 also benefit from a combination of antiangiogenic agents and PD-1 inhibitors: a multicenter real-world study |
| title_full_unstemmed | Patients with uHCC and Child-Pugh B8/9 also benefit from a combination of antiangiogenic agents and PD-1 inhibitors: a multicenter real-world study |
| title_short | Patients with uHCC and Child-Pugh B8/9 also benefit from a combination of antiangiogenic agents and PD-1 inhibitors: a multicenter real-world study |
| title_sort | patients with uhcc and child pugh b8 9 also benefit from a combination of antiangiogenic agents and pd 1 inhibitors a multicenter real world study |
| topic | Hepatocellular Carcinoma Lenvatinib Sorafenib Immune Checkpoint Inhibitors Child-Pugh B |
| url | https://medicaljournalssweden.se/actaoncologica/article/view/42652 |
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