甲磺酸仑伐替尼联合卡瑞利珠单抗治疗晚期肝细胞癌的疗效及安全性

Efficacy and safety of lenvatinib combined with Camrelizumab in the treatment of advanced hepatocellu-lar carcinoma

目的探索甲磺酸仑伐替尼联合卡瑞利珠单抗治疗晚期肝细胞癌的有效性和安全性。方法通过对2020年1月1日至2022年6月30日于新疆生产建设兵团第六师医院使用甲磺酸仑伐替尼与卡瑞利珠单抗联合治疗的33例晚期肝细胞癌患者的回顾性研究。收集患者的临床资料,以修正的实体瘤治疗反应评价标准(mRECIST)评价肝脏原发病灶的疗效,以RECIST1.1标准评价远处转移灶的疗效。Kaplan-Meier法绘制患者的生存曲线,CTCAE 5.0标准评估治疗过程中可能出现的不良反应。结果纳入分析的33例肝细胞癌患者中,8例(24%)疗效评价为部分缓解(PR),13例(39%)疗效评价为疾病稳定(SD),12例(36%)疗效评价为疾病进展(PD),客观缓解率(ORR)为24%,疾病控制率(DCR)为64%。中位无疾病进展时间(mPFS)为5.30个月[95%CI(4.31,6.29)],中位生存时间(OS)为18.50个月[95%CI(16.32,20.68)]。治疗相关不良反应主要包括皮肤毛细血管增生症(58%)、疲乏(48%)、食欲下降(42%)和高血压(36%),未发生致死性不良反应。结论甲磺酸仑伐替尼联合卡瑞利珠单抗治疗晚期肝细胞癌具有较好的临床效果,且不良反应相对可控。

Objective To explore the clinical efficacy and safety of lenvatinib combined with Camre-lizumab in the treatment of advanced hepatocellular carcinoma.Methods A retrospective analysis was conducted on the clinical data of 33 patients with advanced hepatocellular carcinoma who were treated with lenvatinib com-bined with Camrelizumab at Sixth Dirision Hospital of Xinjiang Production and Construction Corps from January 1,2020 to June 30,2022.Patients were fol-lowed up and the efficacy and tolerability of the therapeutic regimen were evaluated.The efficacy to primary liver lesions was evaluated by mRECIST criteria,and the efficacy to dis-tant metastases was evaluated by RECIST 1.1 criteria.Kaplan-Meier method was used to evaluate the patients′survival time,and adverse events were assessed according to CTCAE 5.0 criteria.Results Among the 33 pa-tients,8(24%)achieved partial response(PR),13(39%)achieved stable disease(SD),and 12(36%)achieved progressive disease(PD).The objective response rate(ORR)was 24%,and the disease control rate(DCR)was 64%.The median progression-free survival(mPFS)was 5.30 months,95%CI(4.31,6.29),and the median overall survival time(OS)was 18.50 months,95%CI(16.32,20.68).The treatment-related adverse reactions mainly includ-ed reactive cutaneous capillary endothelial proliferation(58%),fatigue(48%),decreased appetite(42%),and hy-pertension(36%),with no fatal adverse reactions.Conclusion The combination of lenvatinib mesylate and car-relizumab has good clinical efficacy for the treatment of advanced hepatocellular carcinoma,and it has a low inci-dence rate of serious adverse events.