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. 2022 Jul 15;12(7):3455-3463.
eCollection 2022.

Different interventional time of hepatic arterial infusion with PD-1 inhibitor for advanced biliary tract cancer: a multicenter retrospective study

Ting Zhang  1 , Xu Yang  1 , Xiaobo Yang  1 , Kanglian Zheng  2 , Yanyu Wang  1 , Yunchao Wang  1 , Xinting Sang  1 , Xin Lu  1 , Yiyao Xu  1 , Xiaodong Wang  2 , Haitao Zhao  1
Affiliations

Different interventional time of hepatic arterial infusion with PD-1 inhibitor for advanced biliary tract cancer: a multicenter retrospective study

Ting Zhang et al. Am J Cancer Res. .

Abstract

This study investigated the efficacy and safety of hepatic artery infusion chemotherapy (HAIC) combined with PD-1 immunotherapy for advanced biliary tract cancer (BTC) and evaluated the optimal timing of HAIC. A total of 36 unresectable BTC patients treated with HAIC and PD-1 inhibitors between September 2019 and July 2021 were included in this study. Overall survival (OS), progression-free survival (PFS), tumor response, and adverse events (AEs) were investigated. Overall, 52.8% patients with advanced BTC were in stage IV, 23 patients who progressed after receiving PD-1 inhibitor had undergone HAIC, and 23 patients have received 2 or more lines of therapy. The median OS was 8.8 months (range: 4.0-24.0 months), and the median PFS was 3.7 months. The objective response rate and disease control rate were 11.5% and 76.9%, respectively. In the subgroup analysis, patients who treated with HAIC early without progression after immunotherapy were associated with a trend toward better OS (median 13.0 vs. 7.6 months; P = 0.004) and PFS (median 7.9 vs. 3.6 months; P = 0.09) compared to with HAIC with progression after PD-1 treatment. No treatment-related deaths occurred. A total of 44.4% of the patients experienced grade 3 or 4 AEs. We conclude that the combination of HAIC and PD-1 inhibitors is safe and effective. Early HAIC combined with immunotherapy can effectively prolong the overall survival of patients with advanced BTC.

Keywords: Biliary tract cancer; PD-1 inhibitor; combination therapy; hepatic arterial infusion chemotherapy; interventional time of HAIC.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Patient Screening and Enrollment Flowchart.
Figure 2
Figure 2
A. Kaplan-Meier estimation of OS of the entire cohort; B. Kaplan-Meier estimation of PFS of the entire cohort.
Figure 3
Figure 3
A. Kaplan-Meier estimation of OS of advanced BTC patients who treated with first-line systemic therapy (blue line) or second- and third-line systemic therapy (red line); B. Kaplan-Meier estimation of PFS of advanced BTC patients who treated with first-line systemic therapy (blue line) or second- and third-line systemic therapy (red line).
Figure 4
Figure 4
A. Kaplan-Meier estimation of OS of advanced BTC patients who treated HAIC without progression after PD-1 treatment (blue line) or with progression after PD-1 treatment (red line); B. Kaplan-Meier estimation of PFS of advanced BTC patients who treated HAIC without progression after PD-1 treatment (blue line) or with progression after PD-1 treatment (red line).
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