Efficacy of Toripalimab Combined with Lenvatinib and TACE in the Treatment of Advanced Hepatocellular Carcinoma and Its Impact on Tumor Markers and Prognosis
Objective:To explore the efficacy of toripalimab combined with lenvatinib and transarterial chemoembolization(TACE)in the treatment of advanced hepatocellular carcinoma(HCC)and analyze its effects on tumor markers and prognosis.Methods:A total of 108 patients with advanced HCC admitted to the Affiliated Hospital of Xiangya School of Medicine,Central South University(Changde First People's Hospital)from January 2022 to March 2023 were selected and randomly divided into two groups:the study group and the control group,with 54 patients in each group.The control group received lenvatinib+TACE treatment,while the study group received toripalimab+lenvatinib+TACE treatment.Each treatment course lasted 21 days,and three consecutive courses were administered.The treatment efficacy and adverse reactions were compared between the two groups after three courses.Tumor markers[Golgi protein 73(GP73),carcinoembryonic an-tigen(CEA),tumor-specific growth factor(TSGF),carbohydrate antigen 19-9(CA19-9)],immune func-tion(T lymphocyte subsets),serum factors[interleukin-1β(IL-1β),alpha-2-HS-glycoprotein(AH-SG),nuclear factor kappa B(NF-κB),soluble epidermal growth factor receptor 3(sErbB3)],quality of life[FACT-G(Functional Assessment of Cancer Therapy-General)score],and functional status[Karnofsky Performance Status(KPS)score]were compared before and after treatment.Prognosis was assessed within one year after treatment in both groups.Results:The objective response rate(ORR)of the study group was significantly higher than that of the control group(59.26%vs.37.04%,χ2=5.341,P=0.021).After treatment,serum levels of GP73,CEA,TSGF,and CA19-9 in the study group were significantly lower than those in the control group[(198.62±61.79)ng/mL,(20.45±2.48)ng/mL,(62.08±7.12)U/mL,(26.07±3.49)U/mL vs.(237.91±66.35)ng/mL,(25.63±2.79)ng/mL,(70.61±7.59)U/mL,(29.58±3.86)U/mL,P<0.05].The levels of CD3+,CD4+,and CD4+/CD8+in the study group were significantly higher than in the control group(P<0.05).Serum levels of IL-1β,AHSG,NF-κB,and sErbB3 in the study group were lower than those in the control group[(15.88±3.64)pg/mL,(9.39±3.13)ng/mL,(175.49±38.62)ng/L,(2791.36±256.84)ng/mL vs.(20.56±4.37)pg/mL,(11.72±3.41)ng/mL,(212.83±43.57)ng/L,(2983.49±268.07)ng/mL,P<0.05].FACT-G and KPS scores were higher in the study group than in the control group after treatment(P<0.05).There was no significant difference in ad-verse reactions between the two groups(P>0.05).The 1-year survival rate in the study group was 29.63%,significantly higher than the 18.52%in the control group(P<0.05).Conclusion:Toripalimab combined with lenvatinib and TACE has a significant therapeutic effect on advanced hepatocellular carcinoma.It can reduce tumor marker levels,improve immune function and the tumor microenvironment,enhance the quality of life and functional status,and increase the survival rate,with good safety.
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