Objective:To evaluate the efficacy and safety of immune checkpoint inhibitors (ICIs) combined with anti-angiogenic drugs as a first-line treatment for advanced hepatocellular carcinoma (HCC),and analyze the relationship between the expression of PD-L1 and VEGFA in tumor microenvironment and the therapeutic effect.Methods:The clinicopathologic data of 45 patients with advanced HCC who were first-line treated by ICIs and anti-angiogenic drugs were selected.Among the 45 patients,24 cases were treated with camrelizuma and apatinib (group A),and 21 cases were treated with sintilimab and bevacizumab (group B).The efficacy and safety were assessed according to RECIST 1.1 and NCI-CTC 4.0.The expressions of PD-L1 and VEGFA in the tumor microenvironment were examined by immunohistochemical staining and the correlation with therapeutic effect were assessed.Results:Among the 45 HCC patients,the overall objective response rate (ORR) was 28.89％ (13/45),the disease control rate (DCR) was 57.78％ (26/45),and the median progression free survival time (mPFS) was 6.6 months.There was no statistically significant difference in ORR,DCR,and mPFS between group A and group B (P>0.05).There were no treatment-related deaths among the 45 patients,and the incidence of grade 3 or above adverse reactions was 11.11％ (5/45).No new adverse events were found.PD-L1 positive patients had higher ORR,DCR,and mPFS compared to PD-L1 negative patients (P<0.05).There was no statistically significant difference in ORR,DCR,and mPFS between patients with positive and negative expression of VEGFA (P>0.05).Conclusions:Combination treatment with immune checkpoint inhibitors and antiangiogenic drugs has definite antitumor activity in first-line setting for patients with advanced HCC,with an acceptable safety profile.The expression of PD-L1 in the tumor microenvironment is related to the efficacy of combination therapy.
维普
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