Effect of cindilizumab combined with ranvartinib and transcatheter arterial chemoembolization in patients with advanced liver cancer and its influence on cellular immune function

doi:10.3877/cma.j.issn.2095-2015.2025.03.006

Abstract

Abstract:

Objective

To analyze the efficacy of programmed death receptor-1(PD-1) inhibitor cindilizumab combined with multi-target receptor tyrosine kinase inhibitor ranvartinib and transcatheter arterial chemoembolization (TACE) in the treatment of patients with advanced liver cancer and its influence on cellular immune function.

Methods

A total of 100 patients with advanced liver cancer in Huangshan People's Hospital from June 2020 to June 2023 were selected for a controlled study.The observation group (n=50) and the control group (n=50) were included respectively by simple random sampling method.Both groups were treated with cindilizumab combined with ranvartinib, and the observation group was added with TACE.The short-term curative effect, changes of tumor markers and cellular immune function before and after treatment, and the incidence of adverse reactions were compared between the two groups, and their 1-year survival was recorded through follow-up.

Results

After 3 months of treatment, the objective remission rate and disease control rate of the observation group were 42.00% and 82.00% respectively, which were higher than those of the control group (20.00% and 64.00%,respectively) (P<0.05).After 3 months of treatment, AFP, PIVKA-Ⅱ, CEA and CA19-9 in both groups decreased compared with those before treatment, and the levels in the observation group were all lower than those in the control group (P<0.05).After 3 months of treatment, CD3⁺ and CD8⁺ in both groups decreased, while CD4⁺ and CD4⁺/CD8⁺ increased.CD3⁺ and CD8⁺ in the observation group were lower than those in the control group, and CD4⁺ and CD4⁺/CD8⁺ were higher than those in the control group(P<0.05).There was no statistical difference in the incidence of adverse reactions between the two groups(P>0.05).The average progression free survival [(10.17±2.08) months vs.(8.04±1.75) months] and overall survival [(18.83±3.19) months vs.(15.34±2.29) months]of the observation group were longer than those of the control group (P<0.05).

Conclusion

On the basis of cindilizumab combined with ranvartinib, TACE can achieve better short-term efficacy in patients with advanced liver cancer, and can improve tumor markers and immune function without increasing adverse reactions, and prolong survival period.

Key words: Liver cancer, Cindilizumab, Renvartinib, Transcatheter arterial chemoembolization, Cytoimmunity

Jie Hu, Shuhong Wang, Weiwei Zhang. Effect of cindilizumab combined with ranvartinib and transcatheter arterial chemoembolization in patients with advanced liver cancer and its influence on cellular immune function[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2025, 15(03): 219-223.

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URL: https://zhxhbyyxzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-2015.2025.03.006

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Figures/Tables 7

组别	例数	年龄(岁, $\overset{ˉ}{x}$ ± s )	病灶直径(cm, $\overset{ˉ}{x}$ ± s )	性别[例(%)]		BCLC 分期[例(%)]		Child-pugh 分级[例(%)]		转移情况[例(%)]^*
组别	例数	年龄(岁, $\overset{ˉ}{x}$ ± s )	病灶直径(cm, $\overset{ˉ}{x}$ ± s )	男	女	B 期	C 期	A 级	B 级	血管侵犯	远处转移	二者均有
观察组	50	52.84±9.69	5.77±1.23	35(70.00)	15(30.00)	18(36.00)	32(64.00)	36(72.00)	14(28.00)	7(21.88)	18(56.25)	7(21.88)
对照组	50	52.33±9.71	5.85±1.19	37(74.00)	13(26.00)	21(42.00)	29(58.00)	33(66.00)	17(34.00)	9(31.03)	15(51.72)	5(17.24)
t/χ²值		0.263	0.331	0.198		0.378		0.421			0.701
P值		0.793	0.742	0.656		0.539		0.517			0.701

组别	例数	年龄(岁, $\overset{ˉ}{x}$ ± s )	病灶直径(cm, $\overset{ˉ}{x}$ ± s )	性别[例(%)]		BCLC 分期[例(%)]		Child-pugh 分级[例(%)]		转移情况[例(%)]^*
组别	例数	年龄(岁, $\overset{ˉ}{x}$ ± s )	病灶直径(cm, $\overset{ˉ}{x}$ ± s )	男	女	B 期	C 期	A 级	B 级	血管侵犯	远处转移	二者均有
观察组	50	52.84±9.69	5.77±1.23	35(70.00)	15(30.00)	18(36.00)	32(64.00)	36(72.00)	14(28.00)	7(21.88)	18(56.25)	7(21.88)
对照组	50	52.33±9.71	5.85±1.19	37(74.00)	13(26.00)	21(42.00)	29(58.00)	33(66.00)	17(34.00)	9(31.03)	15(51.72)	5(17.24)
t/χ²值		0.263	0.331	0.198		0.378		0.421			0.701
P值		0.793	0.742	0.656		0.539		0.517			0.701

组别	例数	完全缓解	部分缓解	疾病稳定	疾病进展	客观缓解率	疾病控制率
观察组	50	0	21(42.00)	20(40.00)	9(18.00)	21(42.00)	41(82.00)
对照组	50	0	10(20.00)	22(44.00)	18(36.00)	10(20.00)	32(64.00)
χ ²值						5.657	4.110
P值						0.017	0.043

组别	例数	AFP(ng/mL)		PIVKA-Ⅱ(mAU/mL)		CEA(ng/mL)		CA19-9(U/mL)
组别	例数	治疗前	治疗3 个月后	治疗前	治疗3 个月后	治疗前	治疗3 个月后	治疗前	治疗3 个月后
观察组	50	481.34±35.99	188.23±17.61^*	1388.87±164.95	532.36±52.15^*	58.27±9.08	34.21±5.05^*	142.38±21.75	47.08±9.11^*
对照组	50	476.95±37.12	226.95±22.47^*	1369.75±170.24	781.19±61.47^*	58.31±8.75	43.41±5.37^*	144.05±21.24	58.61±10.39^*
t值		0.600	9.590	0.570	21.827	0.022	8.825	0.388	5.900
P值		0.500	＜0.001	0.570	＜0.001	0.982	＜0.001	0.699	＜0.001

组别	例数	CD3⁺(%)		CD4⁺(%)		CD8⁺(%)		CD4⁺/ CD8⁺
组别	例数	治疗前	治疗3 个月后	治疗前	治疗3 个月后	治疗前	治疗3 个月后	治疗前	治疗3 个月后
观察组	50	32.71±4.08	41.89±5.94^*	28.26±3.71	37.94±8.12^*	28.34±1.15	22.08±0.95^*	1.00±0.16	1.72±0.28^*
对照组	50	32.39±3.97	37.06±4.52^*	28.05±3.64	32.66±6.05^*	28.19±1.23	24.12±1.08^*	0.99±0.17	1.35±0.21^*
t值		0.397	4.576	0.286	3.687	0.630	10.029	0.303	7.475
P值		0.692	＜0.001	0.776	＜0.001	0.530	＜0.001	0.763	＜0.001

组别	例数	1～2 级						3～5 级
组别	例数	食欲下降	高血压	蛋白尿	ALT 升高	腹泻	其他	食欲下降	高血压	蛋白尿	ALT 升高	腹泻	其他
观察组	50	21(42.00)	14(28.00)	13(26.00)	12(24.00)	13(26.00)	6(12.00)	0	2(4.00)	1(2.00)	0	1(2.00)	1(2.00)
对照组	50	19(38.00)	13(26.00)	12(24.00)	9(18.00)	10(20.00)	5(10.00)	0	1(2.00)	0	1(2.00)	2(4.00)	0
χ ²值		0.167	0.051	0.053	0.542	0.508	0.102		＜0.001	＜0.001	＜0.001	＜0.001	＜0.001
P值		0.683	0.822	0.817	0.461	0.476	0.749		>0.999	>0.999	>0.999	>0.999	>0.999

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