Objective To evaluate the efficacy and safety of anti-PD-1 immunotherapy combined with anti-angiogenic therapy in the treatment of advanced hepatocellular carcinoma and to explore the potential prognostic factors.Methods We collected the clinical data of patients with advanced hepatocellular carcinoma who were treated with PD-1 inhibitors combined with anti-angiogenic therapy from March 2020 to December 2022 in Huaibei People's Hospital and observed the clinical efficacy,adverse events.Kaplan-Meier was used to analyze the survival benefit.Univariate and multivariate Cox analysis were performed to evaluate the association between prognostic factors and survival outcomes.Results Among the 55 patients enrolled in this study,the objective response rate was 18.2％(10/55)and the disease control rate was 74.5％(41/55).Survival analysis showed that the median progression-free survival(mPFS)was 8.5 months and the median overall survival(mOS)was 17.4 months.Patients who received transcatheter arterial chemoembolization(TA-CE)had better PFS and OS than those who did not(P＜0.005).PFS and OS were longer in patients with lower NLR(mPFS:10.1 months vs.6.5 months;mOS:18.6 months vs.14.9 months,P＜0.05).The most common adverse e-vents were fatigue,hypertension,etc.11 patients experienced grade 3-4 adverse events.Conclusion In this real-world study,anti-PD-1 immunotherapy combined with anti-angiogenic therapy could significantly prolong the survival of ad-vanced HCC patients,especially in patients receiving TACE treatment,and the adverse events were controllable.The pre-treatment serum NLR level is an independent prognostic factor to predict PFS and OS,which could help to screen the potential patients who can benefit from immunotherapy.
维普
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