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ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gastrointestinal Cancers: Hepato Pancreatic Biliary Cancers
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1515640
This article is part of the Research Topic Hepatobiliary tumors: Molecular Targets and Therapeutics View all 4 articles
Efficacy and safety of combined targeted therapy and immunotherapy versus targeted monotherapy in older patients with uHCC
Provisionally accepted
Yu Li 1
Jian-Hong Zhong 2
Xiao-Dong Zhu 3
Chuangye Han 4
Jiabei Wang 5
Hong-Zhi Liu 6
Kuan Hu 7
Yang-Xun Pan 8
Hui-Chuan Sun 3
Tao Peng 4
Lian-Xin Liu 5 Yong-Yi Zeng 6
Le-Du Zhou 7
Li Xu 8
Nan-Ya Wang 1*- 1 First Affiliated Hospital of Jilin University, Changchun, China
- 2 Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Region, China
- 3 Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
- 4 First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi Zhuang Region, China
- 5 Anhui Provincial Hospital, Hefei, Anhui Province, China
- 6 Mengchao Hepatobiliary Hospital, Fuzhou, Fujian Province, China
- 7 Xiangya Hospital, Central South University, Changsha, Hunan Province, China
- 8 Sun Yat-sen University Cancer Center (SYSUCC), Guangzhou, Guangdong Province, China
The prevalence of hepatocellular carcinoma (HCC) among older patients is rising due to the aging population. This study aimed to compare the efficacy and safety of targeted therapy alone versus its combination with immunotherapy in older patients (≥ 65 years old) with unresectable HCC (uHCC).We retrospectively analyzed 158 patients aged ≥ 65 diagnosed with uHCC who received targeted therapy alone or in combination with immunotherapy from the CLEAP database between March 2019 and July 2023. The primary endpoint was overall survival (OS), with secondary endpoints including progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and safety assessments for adverse events (AEs).The ORR was 3.6% in the targeted monotherapy group compared to 29.4% in the combination therapy group, while the DCRs were 53.6% and 54.9%, respectively. Survival analysis indicated a median PFS of 7.3 months for monotherapy versus 13.2 months for combination therapy (P = 0.137) and a median OS of 16.0 months versus 20.0 months, respectively (P = 0.140). AEs occurred in 44.6% of the monotherapy group and 58.8% in the combination therapy group, with 20.5% in the combination group withdrawing due to adverse reactions, significantly higher than in monotherapy group.Among older patients with uHCC, the combination therapy demonstrated higher ORR and longer PFS and OS, although it had higher incidences of AEs and drug withdrawal.
Keywords: Hepatocellular Carcinoma, older patients, Targeted monotherapy, PD-1/PD-L1 combination therapy, clinical outcome
Received: 23 Oct 2024; Accepted: 31 Mar 2025.
Copyright: © 2025 Li, Zhong, Zhu, Han, Wang, Liu, Hu, Pan, Sun, Peng, Liu, Zeng, Zhou, Xu and Wang. 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:
Nan-Ya Wang, First Affiliated Hospital of Jilin University, Changchun, China
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