A study on the clinical value of immunotherapy combined with chemotherapy for advanced intrahepatic cholangiocarcinoma

SHENG Fang; XU Fang; XIE Mengyi; DING Yuan; WANG Chen; YOU Chuan; LI Jingdong; ZHOU Fang; ZHAO Yun

doi:10.3969/j.issn.1674-4136.2024.05.016

Abstract：Objective To assess the clinical value of immunotherapy combined with chemotherapy in the treatment of advanced intrahepatic cholangiocarcinoma(ICC).Methods The clinical and pathological data of 80 patients with advanced ICC,who were treated at two tertiary hospitals from January 2019 to April 2022,were retrospectively collected.There were 50 males and 30 females,aged(58±11)years old(range:29-77 years old).According to whether chemotherapy was combined with immunotherapy,the patients were divided into a chemotherapy-only group(group A,n=26)and an immunotherapy combined with chemotherapy group(group B,n=54).The demographic characteristics,clinicopathological profiles,overall survival rates,progression-free survival rates and treatment-related adverse events were compared between the two groups.The overall curative effect was evaluated by RECIST evaluation criteria,and the objective response rate(ORR)and disease control rate(DCR)were compared between the two groups.Results Among the patients,67.5％received a combination of immunotherapy and chemotherapy.The number of treatment cycles in group A(4±2)was found to be lower than that in group B(5±3)(P＜0.05).However,there were no significant differences observed in other clinicopathological characteristics(all P＞0.05).There was no statistically significant difference in ORR between group A(15.4％)and group B(22.2％)(P＞0.05).However,the DCR in group B was significantly higher than that in group A(76％vs 50％;P＜0.05).The median overall survival time(10 vs.24 months)and the one-,two-,and three-year overall survival rates(39％,20％,7％vs.72％,49％,35％)of patients in group A were significantly lower than those in group B(P＜0.05).However,there was no significant difference between the median progression-free survival time and the one-or two-year overall survival rates(P＞0.05).There was no statistically significant difference in the incidence of grade 1-2 and grade 3-4 adverse events between the two groups(P＞0.05).Gastrointestinal toxicity(diarrhea,abdominal pain)and skin adverse reactions(rash,pruritus)were the most commonly reported treatment-related adverse events associated with immunochemotherapy.Conclusions Patients with ICC may potentially benefit therapeutically from the combination of immunotherapy and chemotherapy;however,the clinical evidence remains limited.Therefore,further research efforts are warranted to advance this combination strategy in the future.