Lu JL, Cheng Y, Xu ZL, Qian GX, Wei MT, Jia WD. Immune checkpoint inhibitors plus anti-angiogenesis in patients with resected high-risk hepatitis B virus-associated hepatocellular carcinoma. World J Gastrointest Oncol 2025; 17(4): 101371 [DOI: 10.4251/wjgo.v17.i4.101371]
Corresponding Author of This Article
Wei-Dong Jia, MD, PhD, Professor, Department of Hepatic Surgery, Anhui Provincial Hospital Affiliated to Anhui Medical University, No. 17 Lujiang Road, Hefei 230001, Anhui Province, China. jwd1968@ustc.edu.cn
Research Domain of This Article
Immunology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jian-Lin Lu, Zi-Ling Xu, Ming-Tong Wei, Wei-Dong Jia, Department of Hepatic Surgery, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei 230001, Anhui Province, China
Yuan Cheng, Gui-Xiang Qian, Department of Hepatic Surgery, Anhui Provincial Hospital, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Science and Medicine, University of Science and Technology of China, Hefei 230001, Anhui Province, China
Co-first authors: Jian-Lin Lu and Yuan Cheng.
Author contributions: Lu JL, Cheng Y, and Jia WD contributed to conception and design, and wrote and revised the manuscript; Lu JL and Cheng Y analyzed and interpreted the data, and contributed equally as co-first authors; Lu JL, Xu ZL, Qian GX, and Wei MT contributed to data acquisition; and all authors have approved the final version to be published.
Supported by the Key Research and Development Projects of Anhui Province, No. 202104j07020048; and National Key Research and Development Program of China, No. 2022YFA1304500.
Institutional review board statement: This study was approved by the Ethics Committee of the Anhui Provincial Hospital Affiliated to Anhui Medical University (No. 2023-RE-392).
Informed consent statement: The need for informed consent was waived owing to the retrospective nature of the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets generated and/or analyzed in the current study are not publicly available because of privacy concerns; however, masked information is available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei-Dong Jia, MD, PhD, Professor, Department of Hepatic Surgery, Anhui Provincial Hospital Affiliated to Anhui Medical University, No. 17 Lujiang Road, Hefei 230001, Anhui Province, China. jwd1968@ustc.edu.cn
Received: September 12, 2024 Revised: January 25, 2025 Accepted: February 13, 2025 Published online: April 15, 2025 Processing time: 194 Days and 9.2 Hours
Abstract
BACKGROUND
Currently, there is a lack of effective adjuvant therapies for patients at high-risk of recurrent hepatitis B virus-associated hepatocellular carcinoma (HBV-HCC) after radical resection. Given the efficacy of anti-programmed death 1/anti-programmed death ligand 1 plus anti-vascular endothelial growth factor receptor agents in advanced HCC, we conducted this study to investigate the efficacy of this combination regimen in the postoperative adjuvant treatment of patients with HBV-HCC.
AIM
To evaluate the value of postoperative combined therapy (PCT) with anti-programmed death 1/anti-programmed death ligand 1 and anti-vascular endothelial growth factor receptor agents in patients with HBV-HCC.
METHODS
Patients with HBV-HCC who underwent radical resection surgery at Anhui Provincial Hospital Affiliated to Anhui Medical University between July 2020 and April 2023 were included. Recurrence-free survival (RFS) and overall survival were assessed using propensity score matching and inverse probability of treatment weighting. Cox regression analysis was used to identify factors affecting recurrence, and subgroup analysis was conducted to investigate the impact of medications on different populations. Treatment-related adverse events and liver function measurements were evaluated.
RESULTS
A total of 150 patients were recruited, of whom 30 underwent PCT and 120 did not. After adjusting for confounders, patients who underwent PCT had better RFS at 6 and 12 months than those who did not (P > 0.05). Similar results were observed in the Kaplan-Meier curves after propensity score matching or inverse probability of treatment weighting, although the difference was not statistically significant (P > 0.05). A maximum diameter of > 5 cm, vascular invasion, satellite nodules, and high gamma-glutamyl transferase levels were independent risk factors for recurrence (P < 0.05). No significant interaction effects were observed in subgroup analyses. The most prevalent adverse event was hypertension (66.7%). PCT was associated with an increased risk of hepatic impairment which may predict RFS rates (P = 0.041).
CONCLUSION
The recurrence rate was not significantly reduced in patients who underwent PCT. Hepatic impairment during treatment may indicate recurrence, and close monitoring of liver function and HBV infection is recommended.
Core Tip: The postoperative combined therapy with anti-programmed death 1/anti-programmed death ligand 1 and anti-vascular endothelial growth factor receptor agents has not been shown to be effective but not significant in reducing early recurrence in patients with hepatitis B virus-associated hepatocellular carcinoma. And thorough evaluation and close monitoring of liver function and hepatitis B-related markers in patients with hepatitis B virus-associated hepatocellular carcinoma are critical when implementing this combined treatment approach.
