Медицинская библиотека · Alimentary pharmacology & therapeutics · 2023

Effect of different PD-1 inhibitor combination therapies for unresectable intrahepatic cholangiocarcinoma.

Lei Zhengqing, Ma Weihu, Si Anfeng, Zhang Yuhua, Yang Facai, Yu Qiushi, Tang Haolan, Xiao Qianru, Zhou Jiahua, Wang Kui, Tang Yufu, Han Tao, Yin Guowen, Chen Jinhong, Liu Xiufeng, Zhao Hua, Yu Decai, Luo Tao, Wang Qing, Yan Maolin, Mao Xianhai, Li Jing, Wang Kai, Li Jingdong, Zeng Yongyi, Ding Dequan, Chen Tingsong, Wu Xiaofeng, Xia Yongxiang, Wang Kang, Guo Weixing, Zhu Guangyu, Gao Shan, Hüser Norbert, Lau Wan Y, Song Tianqiang, Cheng Shuqun, Shen Feng, Cheng Zhangjun

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Аннотация

BACKGROUND

Immune checkpoint inhibitor (ICI) combination therapy offers a new option for treatment of unresectable intrahepatic cholangiocarcinoma (uICC).

AIM: To compare the effect of different anti-PD-1 combination therapies as the first-line treatments for uICC.

METHODS

This study included 318 patients who received chemotherapy alone (Chemo), anti-PD-1 plus chemotherapy (ICI-chemo), anti-PD-1 plus targeted therapy (ICI-target) or anti-PD-1 plus targeted therapy and chemotherapy (ICI-target-chemo) as first line for uICC from 22 centres in China. The primary endpoint was progression-free survival (PFS). Secondary endpoints included overall survival (OS), objective response rate (ORR) and safety.

RESULTS

Patients with ICI-chemo (median PFS [mPFS], 6.3 months; HR: 0.61, 95% CI: 0.42-0.88; p = 0.008; median OS [mOS], 10.7 months; HR: 0.61, 95% CI: 0.39-0.94; p = 0.026), ICI-target (7.2 months; HR: 0.54, 95% CI: 0.36-0.80; p = 0.002; 15.8 months; HR: 0.54, 95% CI: 0.35-0.84; p = 0.006) or ICI-target-chemo (6.9 months; HR: 0.65, 95% CI: 0.47-0.90; p = 0.009; 14.4 months; HR: 0.47, 95% CI: 0.31-0.70; p < 0.001) achieved better clinical outcomes than those with Chemo (3.8 months; 9.3 months). ICI-target was not inferior to ICI-chemo in survival outcomes (HR for PFS: 0.88, 95% CI: 0.55-1.42; p = 0.614; HR for OS: 0.89, 95% CI: 0.51-1.55; p = 0.680). ICI-target-chemo yielded similar prognoses as ICI-chemo (HR for PFS: 1.07, 95% CI: 0.70-1.62; p = 0.764; HR for OS: 0.77, 95% CI: 0.45-1.31; p = 0.328) and ICI-target (HR for PFS: 1.20, 95% CI: 0.77-1.88; p = 0.413; HR for OS: 0.86, 95% CI: 0.51-1.47; p = 0.583) but resulted in more adverse events (p < 0.001; p = 0.010). Multivariable and propensity score analyses supported these findings.

CONCLUSIONS

Among patients with uICC, ICI-chemo or ICI-target provided more survival benefits than Chemo while achieving comparable prognoses and fewer adverse events than ICI-target-chemo.

Для цитирования: Lei Zhengqing, Ma Weihu, Si Anfeng, Zhang Yuhua, Yang Facai, Yu Qiushi, Tang Haolan, Xiao Qianru, Zhou Jiahua, Wang Kui, Tang Yufu, Han Tao, Yin Guowen, Chen Jinhong, Liu Xiufeng, Zhao Hua, Yu Decai, Luo Tao, Wang Qing, Yan Maolin, Mao Xianhai, Li Jing, Wang Kai, Li Jingdong, Zeng Yongyi, Ding Dequan, Chen Tingsong, Wu Xiaofeng, Xia Yongxiang, Wang Kang, Guo Weixing, Zhu Guangyu, Gao Shan, Hüser Norbert, Lau Wan Y, Song Tianqiang, Cheng Shuqun, Shen Feng, Cheng Zhangjun. Effect of different PD-1 inhibitor combination therapies for unresectable intrahepatic cholangiocarcinoma.. Alimentary pharmacology & therapeutics. 2023. DOI: 10.1111/apt.17623.

Предметные рубрики MeSH

Humans Immune Checkpoint Inhibitors Combined Modality Therapy Cholangiocarcinoma Bile Duct Neoplasms Bile Ducts, Intrahepatic

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