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ORIGINAL RESEARCH article

Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1494520
This article is part of the Research Topic Innovative Approaches to Cholangiocarcinoma: Diagnosis, Treatment, and Multidisciplinary Care View all articles

Comparison of Lenvatinib plus Pembrolizumab versus First-line Systemic Chemotherapy for Advanced Intrahepatic Cholangiocarcinoma: A Real-World Retrospective Study

Provisionally accepted
Zhenyun Yang Zhenyun Yang *Weijie Wu Weijie Wu Zhiwen Hu Zhiwen Hu Yizhen Fu Yizhen Fu Zili Hu Zili Hu Yang-Xun Pan Yang-Xun Pan Juncheng Wang Juncheng Wang Jinbin Chen Jinbin Chen Zhongguo Zhou Zhongguo Zhou Yaojun Zhang Yaojun Zhang Minshan Chen Minshan Chen Dandan Hu Dandan Hu
  • Sun Yat-sen University Cancer Center (SYSUCC), Guangzhou, Guangdong Province, China

The final, formatted version of the article will be published soon.

    Background: Systemic chemotherapy (SC) stands the only first-line treatment for advanced intrahepatic cholangiocarcinoma (iCCA) for the past few decades. Immune checkpoint inhibitors (ICIs) have been proved to provide additional benefit in disease control. However, oncological outcome of iCCA remains poor and awaits further improvement with new treatment modalities. Promising results have been observed in lenvatinib plus pembrolizumab (Len-P) as a second-line therapy in iCCA. This study aimed to explore the safety and efficacy of Len-P as a first-line therapy for iCCA patients in real-world clinical practice.We retrospectively enrolled 133 patients with advanced iCCA who received Len-P or SC between May 2019 and May 2023. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and adverse events (AEs) were compared between the two groups.Results: There were 72 patients and 61 patients in the Len-P and SC groups, respectively. The median OS for the Len-P and SC groups was 16.3 and 17.8 months, respectively. The median PFS for the Len-P and SC groups was 8.9 and 11.4 months, respectively. There was no significant difference in ORR and DCR between the Len-P and SC groups (ORR: 22.2% vs. 23%; P=0.92; DCR: 69.4% vs. 77%; P=0.58).Additionally, the overall incidence of AEs was lower in the Len-P group than SC group. Low inflammation-based scores were indicative of favorable outcomes in patients undergoing Len-P therapy.This study demonstrated that Len-P is promising for the treatment of advanced ICC, with highly improved safety. It emerges as a viable treatment alternative for advanced iCCA. Inflammation-based scores show potential utility in identifying individuals likely to derive heightened benefits from Len-P therapy.

    Keywords: intrahepatic cholangiocarcinoma, Lenvatinib, Pembrolizumab, Systemic chemotherapy, Survival, adverse events

    Received: 11 Sep 2024; Accepted: 14 Nov 2024.

    Copyright: © 2024 Yang, Wu, Hu, Fu, Hu, Pan, Wang, Chen, Zhou, Zhang, Chen and Hu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Zhenyun Yang, Sun Yat-sen University Cancer Center (SYSUCC), Guangzhou, 510060, Guangdong Province, China

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