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Transarterial chemoembolization with PD-(L)1 inhibitors plus molecular targeted therapies for hepatocellular carcinoma(CHANCE001)

查看全文 作　　者：Hai-Dong [1]Zhu;Hai-Liang [2]Li;Ming-Sheng [3]Huang;Wei-Zhu [4]Yang;Guo-Wen [5]Yin;Bin-Yan [6]Zhong;Jun-Hui [7]Sun;Zhi-Cheng [1]Jin;Jian-Jian [1]Chen;Nai-Jian [8]Ge;Wen-Bin [9]Ding;Wen-Hui [10]Li;Jin-Hua [11]Huang;Wei [12]Mu;Shan-Zhi [13]Gu;Jia-Ping [14]Li;Hui [15]Zhao;Shu-Wei [16]Wen;Yan-Ming [17]Lei;Yu-Sheng [18]Song;Chun-Wang [19]Yuan;Wei-Dong [20]Wang;Ming [21]Huang;Wei [22]Zhao;Jian-Bing [23]Wu;Song [24]Wang;Xu [25]Zhu;Jian-Jun [26]Han;Wei-Xin [27]Ren;Zai-Ming [28]Lu;Wen-Ge [29]Xing;Yong [30]Fan;Hai-Lan [31]Lin;Zi-Shu [32]Zhang;Guo-Hui [33]Xu;Wen-Hao [34]Hu;Qiang [35]Tu;Hong-Ying [36]Su;Chuan-Sheng [37]Zheng;Yong [38]Chen;Xu-Ya [39]Zhao;Zhu-Ting [40]Fang;Qi [41]Wang;Jin-Wei [42]Zhao;Ai-Bing [43]Xu;Jian [44]Xu;Qing-Hua [45]Wu;Huan-Zhang [46]Niu;Jian [47]Wang;Feng [48]Dai;Dui-Ping [49]Feng;Qing-Dong [50]Li;Rong-Shu [51]Shi;Jia-Rui [52]Li;Guang [53]Yang;Hai-Bin [54]Shi;Jian-Song [55]Ji;Yu-E [56]Liu;Zheng [57]Cai;Po [58]Yang;Yang [59]Zhao;Xiao-Li [6]Zhu;Li-Gong [60]Lu;Gao-Jun [1]Teng 高影响力作者 机构地区：[1]Center of Interventional Radiology&Vascular Surgery,Department of Radiology,Zhongda Hospital,Medical School,Southeast University,Nanjing 210009,China;[2]Department of Minimally invasive Intervention,The Affiliated Cancer Hospital of Zhengzhou University,Zhengzhou 450008,China;[3]Department of Interventional Radiology,the Third Affiliated Hospital,Sun Yat-Sen University,Guangzhou 510630,China;[4]Department of Interventional Radiology,Union Hospital of Fujian Medical University,Fuzhou 350001,China;[5]Department of Interventional Radiology,Jiangsu Cancer Hospital&Jiangsu Institute of Cancer Research&The Affiliated Cancer Hospital of Nanjing Medical University,Nanjing 210009,China;[6]Department of Interventional Radiology,The First Affiliated Hospital of Soochow University,Soochow University,Suzhou 215006,China;[7]Hepatobiliary and Pancreatic Interventional Treatment Center,Division of Hepatobiliary and Pancreatic Surgery,The First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China;[8]Department of Interventional Radiology,Eastern Hospital of Hepatobiliary Surgery,Navy Medical University(Second Military Medical University),Shanghai 200438,China;[9]Department of Interventional Radiology,Nantong First People’s Hospital,Nantong 226001,China;[10]Department of Interventional Radiology,Yancheng Third People’s Hospital,Yancheng 224008,China;[11]Department of Minimally Invasive Interventional Therapy,Sun YatSen University Cancer Center,Guangzhou 510060,China;[12]Department of Vascular Surgery,Southwest Hospital,Third Military Medical University(Army Medical University),Chongqing 400038,China.;[13]Department of Interventional Radiology,Hunan Cancer Hospital,Changsha 410031,China;[14]Department of Interventional Oncology,The First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China;[15]Department of Interventional Radiology,The Hospital of Nantong University,Nantong 226001,China;[16]Department of Interventional Therapy,Shanxi Tumor Hospital,Taiyuan 030001,China;[17]Department of Interventional Radiology,Tibet Autonomous Region People’s Hospital,Lhasa 850000,China;[18]Department of Interventional Radiology,Ganzhou People’s Hospital,Ganzhou 341000,China;[19]Center of Interventional Oncology and Liver Diseases,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China;[20]Department of Interventional Radiology,The Affiliated Wuxi People’s Hospital of Nanjing Medical University,Wuxi 214023,China;[21]Department of Minimally Invasive Interventional Therapy,Yunnan Tumor Hospital,The Third Affiliated Hospital of Kunming Medical University,Kunming 650118,China;[22]Department of Radiology,First Affiliated Hospital of Kunming Medical University,Kunming 650032,China;[23]Department of Oncology,The Second Affiliated Hospital of Nanchang University,Nanchang 330006,China;[24]Department of Interventional Radiology,Affiliated Hospital of Qingdao University,Qingdao 266000,China;[25]Department of Interventional Therapy,Peking University Cancer Hospital and Institute,Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education),Beijing 100142,China;[26]Department of Interventional Radiology,Affiliated Cancer Hospital of Shandong First Medical University,Jinan 250117,China;[27]Interventional Therapy Center,The first Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,China;[28]Department of Radiology,Shengjing Hospital of China Medical University,Shenyang 830011,China;[29]Department of Interventional Oncology,Tianjin Medical University Cancer Hospital,Tianjin 300060,China;[30]Department of Radiology,Tianjin Medical University General Hospital,Tianjin 300052,China;[31]Department of Tumor Interventional Therapy,Fujian Cancer Hospital,Fuzhou 350014,China;[32]Department of Radiology,The Second Xiangya Hospital,Changsha 410011,China;[33]Department of Interventional Radiology,Sichuan Cancer Hospital and Institute,Chengdu 610041,China;[34]Department of Interventional Radiology,First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China;[35]Department of Hepatobiliary Oncology Surgery,Department of Interventional Oncology,Jiangxi Cancer Hospital of Nanchang University,Nanchang 330029,China;[36]Department of Interventional Radiology,The First Hospital of China Medical University,Shenyang 110001,China;[37]Department of Radiology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 110001,China;[38]Department of Interventional Radiology,General hospital of Ningxia Medical University,Yinchuan 110001,China;[39]Department of Interventional Radiology,Guizhou Cancer Hospital,Guiyang 550000,China;[40]Department of Interventional Radiology,Fujian Provincial Hospital,Shengli Clinical Medical College of Fujian Medical University,Fuzhou 350001,China;[41]Department of Interventional Radiology,Third Affiliated Hospital of Soochow University,Changzhou First Hospital,Changzhou 213004,China;[42]Department of Interventional and Vascular Surgery,The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University,Changzhou 213003,China;[43]Department of Interventional Therapy,Nantong Tumor Hospital,Nantong 226006,China;[44]Department of Interventional Therapy,Jinling Hospital,School of Medicine,Nanjing University,Nanjing 210002,China;[45]Department of Interventional Radiology,Affiliated Hospital of Jiangnan University,Wuxi 214122,China;[46]Department of Interventional Radiology,The First Affiliated Hospital,and College of Clinical Medicine of Henan University of Science and Technology,Luoyang 471003,China;[47]Department of Interventional Radiology and Vascular Surgery,Peking University First Hospital,Beijing 100034,China;[48]Department of Interventional Radiology,The Second Hospital of Nanjing,Nanjing 210000,China;[49]Department of Oncology and Vascular Intervention,First Hospital of Shanxi Medical University,Taiyuan 030001,China;[50]Vascular and Interventional Department,Chongqing University Cancer Hospital,Chongqing 400000,China;[51]Department of Interventional Radiology,The Affiliated Hospital of Zunyi Medical College,Zunyi 563000,China;[52]Department of Interventional Therapy,The First Hospital of Jilin University,Changchun 130000,China;[53]Department of Radiology,The Fourth Hospital of Hebei Medical University,Shijiazhuang,China;[54]Department of Interventional Radiology,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;[55]Department of Radiology,Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research,School of Medicine,Lishui Hospital of Zhejiang University,Lishui 323000,China;[56]Department of Interventional Radiology,Shanxi Provincial People’s Hospital,Taiyuan 030012,China;[57]Department of Interventional Medicine,The Second Affiliated Hospital of Zunyi Medical University,Zunyi 563000,China;[58]Department of Interventional&Vascular Surgery,The Fourth Hospital of Harbin Medical University,Harbin 150001,China;[59]Department of Biostatistics,Nanjing Medical University,Nanjing 211166,China;[60]Zhuhai Interventional Medical Center,Zhuhai Precision Medical Center,Zhuhai People’s Hospital,Zhuhai Hospital Affiliated with Jinan University,Jinan University,Zhuhai 519000,China高影响力机构 出　　处：《Signal Transduction and Targeted Therapy》索引2023年第8卷第3期,共10页高影响力期刊 基　　金：The study was supported by National Key Research and Development Program(2018YFA0704100,2018YFA0704104);National Natural Science Foundation of China(81827805,82130060);Jiangsu Provincial Special Program of Medical Science(BE2019750).The funding sources had no role in the writing of the report,or decision to submit the paper for publication. 摘　　要：There is considerable potential for integrating transarterial chemoembolization(TACE),programmed death-(ligand)1(PD-[L]1)inhibitors,and molecular targeted treatments(MTT)in hepatocellular carcinoma(HCC).It is necessary to investigate the therapeutic efficacy and safety of TACE combined with PD-(L)1 inhibitors and MTT in real-world situations.In this nationwide,retrospective,cohort study,826 HCC patients receiving either TACE plus PD-(L)1 blockades and MTT(combination group,n=376)or TACE monotherapy(monotherapy group,n=450)were included from January 2018 to May 2021.The primary endpoint was progression-free survival(PFS)according to modified RECIST.The secondary outcomes included overall survival(OS),objective response rate(ORR),and safety.We performed propensity score matching approaches to reduce bias between two groups.After matching,228 pairs were included with a predominantly advanced disease population.Median PFS in combination group was 9.5 months(95%confidence interval[CI],8.4-11.0)versus 8.0 months(95%CI,6.6-9.5)(adjusted hazard ratio[HR],0.70,P=0.002).OS and ORR were also significantly higher in combination group(median OS,19.2[16.1-27.3]vs.15.7 months[13.0-20.2];adjusted HR,0.63,P=0.001;ORR,60.1%vs.32.0%;P<0.001).Grade 3/4 adverse events were observed at a rate of 15.8%and 7.5%in combination and monotherapy groups,respectively.Our results suggest that TACE plus PD-(L)1 blockades and MTT could significantly improve PFS,OS,and ORR versus TACE monotherapy for Chinese patients with predominantly advanced HCC in real-world practice,with an acceptable safety profile. 关 键 词：HEPATOCELLULAR TARGETED MATCHING
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