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BMC Cancer: Propensity Score Matching (PSM) Study Shows Anti-PD-1 Combined with Sorafenib Improves Outcomes in Patients with Advanced Hepatocellular Carcinoma Compared with Anti-PD-1 Monotherapy

 Last Update: 2022-01-23
 Source: Internet
 Author: User

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Vascular endothelial growth factor (VEGF) plays a role in the tumor microenvironment
.
Sorafenib inhibits the VEGF pathway and has immunomodulatory functions, but a large number of clinical data are lacking
.
Therefore, scholars from Taipei, China conducted a propensity score matching (PSM) study to investigate the efficacy of anti-PD-1 combined with sorafenib in the treatment of advanced hepatocellular carcinoma
.
The results were published in the journal BMC Cancer
.

We reviewed HCC patients who received anti-PD-1 therapy at Taipei Veterans General Hospital (Taipei) from January 2016 to February 2019
.
After propensity score matching, the therapeutic effects of the two groups were compared
.

A total of 173 patients were screened , and 140 patients with HCC were finally included.
58 patients received anti-PD-1 combined with sorafenib, and 82 received anti-PD-1 alone.
The median follow-up time was 9.
1 months
.
Nivolumab treated 123 patients (87.
9%) and pembrolizumab treated 17 patients (12.
1%)
.
Before matching, the combined group had significantly higher ALBI scores than the control group, significantly higher PVT than the control group (74.
1% vs.
46.
3%, p<0.
05) and more advanced BCLC stage (94.
8% vs.
81.
7% for stage C, p<0.
05) )
.

Compared with anti-PD-1 alone
.
After pairing, DCR remained higher for combination therapy
.

Compared with anti-PD-1 alone
.
After pairing, DCR remained higher for combination therapy
.
Compared with anti-PD-1 alone
.
After pairing, DCR remained higher for combination therapy
.
Compared withanti-PD-1 alone
.
After pairing, DCR remained higher for combination therapy
.
one

Efficacy evaluation before and after PSM

After pairing, the combination group achieved longer progression-free survival (3.
87 vs.
2.
43 months, HR 0.
62, [0.
38–1.
00], p<0.
05) and overall survival (not reached vs.
7.
17 months, HR 0.
62, [0.
38–1.
00], p<0.
05)
.
After pairing, the combination group achieved longer progression-free survival (3.
87 vs.
2.
43 months, HR 0.
62, [0.
38–1.
00], p<0.
05) and overall survival (not reached vs.
7.
17 months, HR 0.
62, [0.
38–1.
00], p<0.
05)
.

PFS and OS after PSM

Subgroup analyses also found that combination therapy improved PFS and OS in most subgroups compared with anti-PD-1 monotherapy
.

Subgroup analyses also found that combination therapy improved PFS and OS in most subgroups compared with anti-PD-1 monotherapy
.
Subgroup analyses also found that combination therapy improved PFS and OS in most subgroups compared with anti-PD-1 monotherapy
.

Subgroup analysis

The decrease in AFP correlated with the CR rate and ORR of the treatment, and the greater the decrease, the higher the CR rate and ORR in the combination therapy group
.

The decrease in AFP correlated with the CR rate and ORR of the treatment, and the greater the decrease, the higher the CR rate and ORR in the combination therapy group
.
The decrease in AFP correlated with the CR rate and ORR of the treatment, and the greater the decrease, the higher the CR rate and ORR in the combination therapy group
.

The relationship between AFP changes and curative effect

In conclusion, this study shows for the first time that anti-PD-1 combined with sorafenib improves the prognosis of patients with advanced hepatocellular carcinoma compared with anti-PD-1 monotherapy
.
This study is the first to show that anti-PD-1 combined with sorafenib improves the prognosis of patients with advanced hepatocellular carcinoma compared with anti-PD-1 monotherapy
.
This study is the first to show that anti-PD-1 combined with sorafenib improves the prognosis of patients with advanced hepatocellular carcinoma compared with anti-PD-1 monotherapy
.

Original source:

Chen SC, Huang YH, Chen MH, Hung YP, Lee RC, Shao YY, Chao Y.
Anti-PD-1 combined sorafenib versus anti-PD-1 alone in the treatment of advanced hepatocellular cell carcinoma: a propensity score-matching study .
BMC Cancer.
2022 Jan 11;22(1):55.
doi: 10.
1186/s12885-022-09173-4.
PMID: 35016637.

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