Effect of different <scp>PD</scp>‐1 inhibitor combination therapies for unresectable intrahepatic cholangiocarcinoma-Reference-Cited by-同舟云学术

Effect of different PD‐1 inhibitor combination therapies for unresectable intrahepatic cholangiocarcinoma

Published:2023-06-22 Issue:6 Volume:58 Page:611-622
ISSN:0269-2813
Container-title:Alimentary Pharmacology & Therapeutics
language:en
Short-container-title:Aliment Pharmacol Ther

Author:

Lei Zhengqing¹,Ma Weihu¹,Si Anfeng²,Zhang Yuhua³,Yang Facai¹,Yu Qiushi¹,Tang Haolan¹,Xiao Qianru¹,Zhou Jiahua¹,Wang Kui⁴,Tang Yufu⁵,Han Tao⁶,Yin Guowen⁷,Chen Jinhong⁸,Liu Xiufeng⁹,Zhao Hua¹⁰,Yu Decai¹¹,Luo Tao¹²,Wang Qing¹³,Yan Maolin¹⁴^ORCID,Mao Xianhai¹⁵,Li Jing¹⁶,Wang Kai¹⁷,Li Jingdong¹⁸,Zeng Yongyi¹⁹,Ding Dequan²⁰,Chen Tingsong²¹,Wu Xiaofeng²²,Xia Yongxiang²²,Wang Kang²³,Guo Weixing²³,Zhu Guangyu²⁴,Gao Shan²⁵,Hüser Norbert²⁶,Lau Wan Y.²⁷,Song Tianqiang²⁸,Cheng Shuqun²³,Shen Feng²⁹,Cheng Zhangjun¹^ORCID

Affiliation:

1. Hepato‐Pancreato‐Biliary Center Zhongda Hospital, School of Medicine, Southeast University Nanjing China

2. Department of Surgical Oncology Qin Huai Medical District of Jinling Hospital, Nanjing University Nanjing China

3. Department of Hepatobiliary and Pancreatic Surgery Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer, Chinese Academy of Sciences Hangzhou China

4. Department of Hepatic Surgery II The Eastern Hepatobiliary Surgery Hospital, Naval Medical University Shanghai China

5. Department of Hepatobiliary Surgery General Hospital of Northern Theater Command Shenyang China

6. Department of Medical Oncology the First Hospital of China Medical University Shenyang China

7. Interventional Radiology Department Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University Nanjing China

8. Department of General Surgery Huashan Hospital & Cancer Metastasis Institute, Fudan University Shanghai China

9. Department of Medical Oncology of PLA Cancer Center Jinling Hospital Nanjing China

10. Department of General Surgery The First Affiliated Hospital of Soochow University Suzhou China

11. Department of Hepatobiliary Surgery The Affiliated Drum Tower Hospital, Medical School of Nanjing University Nanjing China

12. Key Laboratory of Tumor Immunopathology, Ministry of Education of China Institute of Pathology and Southwest Hospital, Third Military Medical University (Army Medical University) Chongqing China

13. Department of General Surgery Zibo Central Hospital Zibo China

14. Department of Hepatobiliary Pancreatic Surgery Fujian Provincial Hospital Fuzhou China

15. Department of Hepatobiliary Surgery Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University Changsha China

16. Department of Hepatobiliary The Second Affiliated Hospital of Army Medical University Chongqing China

17. Department of General Surgery, Jiangxi Provincial Clinical Research Center for General Surgery Disease The Second Affiliated Hospital of Nanchang University Nanchang China

18. Department of Hepatobiliary Surgery Affiliated Hospital of North Sichuan Medical College Nanchong China

19. Department of Hepatobiliary Surgery Mengchao Hepatobiliary Hospital, Fujian Medical University Fuzhou China

20. Department of Interventional Radiology Maanshan People's Hospital Maanshan China

21. Department of Oncology Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine Shanghai China

22. Hepatobiliary Center, Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, NHC Key Laboratory of Liver Transplantation The First Affiliated Hospital of Nanjing Medical University Nanjing China

23. Department of Hepatic Surgery VI The Eastern Hepatobiliary Surgery Hospital, Naval Medical University Shanghai China

24. Center of Interventional Radiology & Vascular Surgery, Department of Radiology Zhongda Hospital, School of Medicine, Southeast University Nanjing China

25. Zhongda Hospital, School of Life Sciences and Technology, Advanced Institute for Life and Health, Southeast University Nanjing China

26. Department of Surgery TUM School of Medicine, Klinikum rechts der Isar, Technical University of Munich Munich Germany

27. Faculty of Medicine The Chinese University of Hong Kong Hong Kong Special Administrative Region China

28. Liver Cancer Center, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer Tianjin Medical University Cancer Institute and Hospital Tianjin China

29. Department of Hepatic Surgery IV The Eastern Hepatobiliary Surgery Hospital, Naval Medical University Shanghai China

Abstract

SummaryBackgroundImmune checkpoint inhibitor (ICI) combination therapy offers a new option for treatment of unresectable intrahepatic cholangiocarcinoma (uICC).AimTo compare the effect of different anti‐PD‐1 combination therapies as the first‐line treatments for uICC.MethodsThis study included 318 patients who received chemotherapy alone (Chemo), anti‐PD‐1 plus chemotherapy (ICI‐chemo), anti‐PD‐1 plus targeted therapy (ICI‐target) or anti‐PD‐1 plus targeted therapy and chemotherapy (ICI‐target‐chemo) as first line for uICC from 22 centres in China. The primary endpoint was progression‐free survival (PFS). Secondary endpoints included overall survival (OS), objective response rate (ORR) and safety.ResultsPatients with ICI‐chemo (median PFS [mPFS], 6.3 months; HR: 0.61, 95% CI: 0.42–0.88; p = 0.008; median OS [mOS], 10.7 months; HR: 0.61, 95% CI: 0.39–0.94; p = 0.026), ICI‐target (7.2 months; HR: 0.54, 95% CI: 0.36–0.80; p = 0.002; 15.8 months; HR: 0.54, 95% CI: 0.35–0.84; p = 0.006) or ICI‐target‐chemo (6.9 months; HR: 0.65, 95% CI: 0.47–0.90; p = 0.009; 14.4 months; HR: 0.47, 95% CI: 0.31–0.70; p < 0.001) achieved better clinical outcomes than those with Chemo (3.8 months; 9.3 months). ICI‐target was not inferior to ICI‐chemo in survival outcomes (HR for PFS: 0.88, 95% CI: 0.55–1.42; p = 0.614; HR for OS: 0.89, 95% CI: 0.51–1.55; p = 0.680). ICI‐target‐chemo yielded similar prognoses as ICI‐chemo (HR for PFS: 1.07, 95% CI: 0.70–1.62; p = 0.764; HR for OS: 0.77, 95% CI: 0.45–1.31; p = 0.328) and ICI‐target (HR for PFS: 1.20, 95% CI: 0.77–1.88; p = 0.413; HR for OS: 0.86, 95% CI: 0.51–1.47; p = 0.583) but resulted in more adverse events (p < 0.001; p = 0.010). Multivariable and propensity score analyses supported these findings.ConclusionsAmong patients with uICC, ICI‐chemo or ICI‐target provided more survival benefits than Chemo while achieving comparable prognoses and fewer adverse events than ICI‐target‐chemo.

Funder

Jiangsu Provincial Key Research and Development Program

National Natural Science Foundation of China

Publisher

Wiley

Subject

Pharmacology (medical),Gastroenterology,Hepatology

Link

https://onlinelibrary.wiley.com/doi/pdf/10.1111/apt.17623

Reference31 articles.

1. Systemic therapies for intrahepatic cholangiocarcinoma

2. Cisplatin plus Gemcitabine versus Gemcitabine for Biliary Tract Cancer