Safety and efficacy of argon-helium cryoablation combined with targeted therapy and anti-programmed death-1 monoclonal antibody in treatment of patients with unresectable hepatocellular carcinoma aged 60 years or older
- VernacularTitle:氩氦刀冷冻消融联合靶向药物和程序性死亡受体1单抗治疗年龄>60岁不可切除肝细胞癌患者的效果及安全性分析
- Author:
Shujuan GONG
1
;
Xiujuan CHANG
1
;
Yan LIU
2
;
Dong JI
1
;
Yan CHEN
3
;
Quanwei HE
4
;
Yongping YANG
1
Author Information
- Publication Type:Journal Article
- Keywords: Carcinoma， Hepatocellular; Cryosurgery; Molecular Targeted Therapy; Immune Checkpoint Inhibitors
- From: Journal of Clinical Hepatology 2026;42(3):629-638
- CountryChina
- Language:Chinese
- Abstract: ObjectiveTo investigate whether anti-programmed death-1 （PD-1） monoclonal antibody can enhance the efficacy and safety of argon-helium cryoablation combined with targeted therapy in patients with unresectable hepatocellular carcinoma （uHCC） aged 60 years or older. MethodsA retrospective analysis was performed for the clinical data of 124 patients with advanced uHCC aged 60 years or older who were treated at The Fifth Medical Center of Chinese PLA General Hospital from January 2013 to September 2024. After propensity score matching， 57 patients received cryoablation combined with targeted therapy （double combination group）， while 57 received cryoablation combined with targeted therapy and anti-PD-1 monoclonal antibody （triple combination group）. The indicators for efficacy assessment included objective response rate （ORR）， disease control rate （DCR）， progression-free survival （PFS）， overall survival （OS）， and the incidence rate of adverse events. The Mann-Whitney U test was used for comparison of continuous data between two groups， and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. The Kaplan-Meier method was used to plot survival curves， and the Log-rank test was used for comparison between groups. A Cox proportional-hazards regression model analysis was used to investigate the influencing factors for survival prognosis. ResultsThe triple combination group had a significantly higher ORR than the double combination group （59.6% vs 29.8%， χ2=9.083， P=0.003）， while there was no significant difference in DCR between the two groups （87.7% vs 77.2%， χ2=1.516， P=0.218）， and compared with the double combination group， the triple combination group had significantly longer median PFS （9.1 months vs 4.8 months， χ2=7.813， P=0.005） and median OS （26.1 months vs 13.6 months， χ2=14.199， P<0.001）. The multivariate Cox proportional-hazards regression model analysis showed that triple combination treatment was an independent influencing factor for PFS （hazard ratio ［HR］=0.52， 95% confidence interval ［CI］： 0.35 — 0.78， P=0.001） and OS （HR=0.32， 95%CI： 0.20 — 0.51， P<0.001）. There was no significant difference in the incidence rate of adverse events between the two groups （P>0.05）. ConclusionTriple combination treatment with argon-helium cryoablation， targeted therapy， and anti-PD-1 monoclonal antibody can significantly improve survival benefits in uHCC patients aged 60 years or older， with a controllable safety profile.
