首页|Radiotherapy enhances efficacy of PD-1 inhibitors in advanced hepatocellular carcinoma:A propensity-matched real-world study

Radiotherapy enhances efficacy of PD-1 inhibitors in advanced hepatocellular carcinoma:A propensity-matched real-world study

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Background:To address the need for immunotherapy in patients with advanced primary hepatocellular carcinoma(HCC),com-bination with radiotherapy(RT)has emerged as a promising strategy.In preclinical studies,irradiated tumors released tumor antigens to synergistically increase the antitumor effect of immunotherapy.Hence,we investigated whether RT enhances the efficacy of anti-programmed death receptor-1(PD-1)inhibitors in advanced HCC in real-world practice.Methods:Between August 2018 and June 2021,172 patients with advanced primary HCC were enrolled in the tertiary center(Zhongshan Hospital of.Fudan University);95 were treated with a combination of RT and the inhibitor of PD-1(RT-PD1 cohort),and 77 were administered anti-PD-1 therapy(PD1 cohort).The first cycle of PD-1 inhibitors was administered within 60 days or concurrently with RT.Propensity score matching for bias reduction was used to evaluate the clinical outcomes.Results:Among 71 propensity-matched pairs,median progression-free survival was 5.7 months in the RT-PD1 cohort vs.2.9 months in the PD1 cohort(P<0.001).Median overall survival was 20.9 months in the RT-PD1 cohort vs.11.2 months in the PD1 cohort(P=0.018).Compared with patients in the PD1 cohort,patients in the RT-PD1 cohort had significantly higher objective response rates(40.8%,29/71 vs.19.7%,14/71,P=0.006)and disease control rates(62.0%,44/71 vs.31.0%,22/71,P<0.001).The incidences of toxic effects were not significantly different between the two cohorts.Conclusions:RT plus anti-PD-1 therapy is well tolerated.RT enhances the efficacy of anti-PD-1 therapy in patients with advanced primary HCC by improving survival outcomes without increased toxic effects.

RadiotherapyImmune checkpoint inhibitorProgrammed cell death receptor-1Hepatocellular carcinomaPropensity score matchingTreatment outcomeAdverse effects

Shujung Hsu、Yencheng Chao、Yong Hu、Yang Zhang、Weifeng Hong、Yixing Chen、Rongxin Chen、Zhaochong Zeng、Shisuo Du

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Department of Radiation Oncology,Zhongshan Hospital,Fudan University,Shanghai 200032,China

Department of Pulmonary Medicine,Zhongshan Hospital,Fudan University,Shanghai 200032,China

Department of Liver Cancer Institute,Zhongshan Hospital,Fudan University,Shanghai 200032,China

National Natural Science Foundation of China

82073479

2024

中华医学杂志(英文版)
中华医学会

中华医学杂志(英文版)

CSTPCD
影响因子:0.838
ISSN:0366-6999
年,卷(期):2024.137(11)
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