간세포암 환자에서 바이러스 병인에 따른 면역관문억제제의 효과 및 안전성 비교
Comparative Effectiveness and Safety of Immune Checkpoint Inhibitors in Patients with Hepatocellular Carcinoma Based on Viral Etiology
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Background : Immune checkpoint inhibitors (ICI) are antitumor agents employed in the treatment of hepatocellular carcinoma (HCC), which enhance T-cell function by targeting immune escape pathways. HCC is classified into viral and non-viral types based on its eti ology, with the viral form often linked to an immunosuppressive microenvironment due to T-cell tolerance. However, existing research on how viral etiology influences ICI therapy outcomes is limited. This study evaluated the efficacy and safety of ICI in viral versus non-viral HCC in a Korean population. Methods : We conducted a retrospective analysis of electronic medical records from pa tients aged 18 and older who initiated ICI treatment for HCC from July 2017 to June 2023 at a tertiary hospital in Korea. The patients were categorized into viral and non-viral groups, with data analyzed up to 3 years following the initiation of ICI treatment. Results : Of 495 patients, 76.6% were in the viral group and 23.4% in the non-viral group. No significant differences were observed between the two groups in terms of progres sion-free survival (median: 101 days vs. 126 days), overall survival (median: 419 days vs. 759 days), or the objective response rate (11.6% vs. 14.7%). The incidence of immune-re lated adverse events was also comparable (7.4% vs. 8.6%). Conclusion : This study holds significance as it evaluates the clinical outcomes of ICI treat ments in HCC patients in Korea, considering their viral etiology. The findings suggest that viral etiology does not significantly impact the effectiveness or safety of ICI treatment in these patients. However, the limitations of this single-center retrospective study regard ing data collection and factor control necessitate future large-scale prospective studies for more definitive conclusions.
Abstract
Background : Immune checkpoint inhibitors (ICI) are antitumor agents employed in the treatment of hepatocellular carcinoma (HCC), which enhance T-cell function by targeting immune escape pathways. HCC is classified into viral and non-viral types based on its eti ology, with the viral form often linked to an immunosuppressive microenvironment due to T-cell tolerance. However, existing research on how viral etiology influences ICI therapy outcomes is limited. This study evaluated the efficacy and safety of ICI in viral versus non-viral HCC in a Korean population. Methods : We conducted a retrospective analysis of electronic medical records from pa tients aged 18 and older who initiated ICI treatment for HCC from July 2017 to June 2023 at a tertiary hospital in Korea. The patients were categorized into viral and non-viral groups, with data analyzed up to 3 years following the initiation of ICI treatment. Results : Of 495 patients, 76.6% were in the viral group and 23.4% in the non-viral group. No significant differences were observed between the two groups in terms of progres sion-free survival (median: 101 days vs. 126 days), overall survival (median: 419 days vs. 759 days), or the objective response rate (11.6% vs. 14.7%). The incidence of immune-re lated adverse events was also comparable (7.4% vs. 8.6%). Conclusion : This study holds significance as it evaluates the clinical outcomes of ICI treat ments in HCC patients in Korea, considering their viral etiology. The findings suggest that viral etiology does not significantly impact the effectiveness or safety of ICI treatment in these patients. However, the limitations of this single-center retrospective study regard ing data collection and factor control necessitate future large-scale prospective studies for more definitive conclusions.
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