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Radiotherapy enhances efficacy of PD-1 inhibitors in advanced hepatocellular carcinoma:A propensity-matched real-world study

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Chinese Medical Journal 2024年第11期137卷 1332-1342页

作者： shujung hsu Yencheng Chao Yong Hu Yang Zhang Weifeng Hong Yixing Chen Rongxin Chen Zhaochong Zeng Shisuo Du Department of Radiation Oncology Zhongshan HospitalFudan UniversityShanghai 200032China Department of Pulmonary Medicine Zhongshan HospitalFudan UniversityShanghai 200032China Department of Liver Cancer Institute Zhongshan HospitalFudan UniversityShanghai 200032China

Background:To address the need for immunotherapy in patients with advanced primary hepatocellular carcinoma(HCC),combination with radiotherapy(RT)has emerged as a promising *** preclinical studies,irradiated tumors released tumor antigens to synergistically increase the antitumor effect of ***,we investigated whether RT enhances the efficacy of anti-programmed death receptor-1(PD-1)inhibitors in advanced HCC in real-world ***:Between August 2018 and June 2021,172 patients with advanced primary HCC were enrolled in the tertiary center(Zhongshan Hospital of Fudan University);95 were treated with a combination of RT and the inhibitor of PD-1(RT-PD1 cohort),and 77 were administered anti-PD-1 therapy(PD1 cohort).The first cycle of PD-1 inhibitors was administered within 60 days or concurrently with *** score matching for bias reduction was used to evaluate the clinical ***:Among 71 propensity-matched pairs,median progression-free survival was 5.7 months in the RT-PD1 cohort vs.2.9 months in the PD1 cohort(P<0.001).Median overall survival was 20.9 months in the RT-PD1 cohort vs.11.2 months in the PD1 cohort(P=0.018).Compared with patients in the PD1 cohort,patients in the RT-PD1 cohort had significantly higher objective response rates(40.8%,29/71 vs.19.7%,14/71,P=0.006)and disease control rates(62.0%,44/71 vs.31.0%,22/71,P<0.001).The incidences of toxic effects were not significantly different between the two ***:RT plus anti-PD-1 therapy is well *** enhances the efficacy of anti-PD-1 therapy in patients with advanced primary HCC by improving survival outcomes without increased toxic effects.

关键词： Radiotherapy Immune checkpoint inhibitor Programmed cell death receptor-1 Hepatocellular carcinoma Propensity score matching Treatment outcome Adverse effects

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