971P - Chemotherapy combined with lenvatinib and PD-1 may be a potential better alternative optionfor advanced unresectable intrahepatic cholangiocarcinoma: A retrospective real-world study

Background

Currently, the prognosis of advanced intrahepatic cholangiocarcinoma (ICC) is poor, and the current treatment methods are not effective. There is some clinical evidence that chemotherapy combined with programmed cell death protein-1(PD-1) inhibitors and tyrosine kinase inhibitor (TKI) can help improve the clinical outcomes of patients with advanced ICC.

Methods

We retrospectively screened patients with advanced intrahepatic cholangiocarcinoma (ICC) who received chemotherapy combined with lenvatinib and PD-1.We evaluated overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), tumor shrinkage rate, and safety.

Results

We enrolled 95 patients with ICC and divided them into three groups. The median follow-up duration was 15.1 months. The chemotherapy group (Chemo group), chemotherapy combined with immune checkpoint inhibitors (Dual-regimen group), and chemotherapy-ICI-lenvatinib (Triple-regimen group) had median OS of 13.1 months, 20.8 months, and 39.6 monthsrespectively.Notably, the triple-regimen group demonstrated a significantly longer OS than the chemotherapy and dual-regimen groups did. For PFS, the chemo group, dual-regimen group, and triple-regimen group reported median durations of 4.8 months, 11.9 months, and 23.4 months, respectively. Both combination groups showed significantly longer PFS than the chemotherapy -only group (P<0.05). The average early tumor shrinkage rates in the three groups were 1.676 %, -36.55%, and -34.22%.The combination therapy groups exhibited better tumor shrinkage than the chemotherapy group (P<0.05). The ORR in the were 18.2%, 55.5%, and 54.7%, respectively. The DCRs were 72.7%, 90%, and 96.2%, respectively, indicating significantly better outcomes in the combination therapy group. In addition, Two patients with ICC experienced significant tumor shrinkage after treatment and underwent surgical resection.

Conclusions

The combination of chemotherapy with PD-1 inhibitors and lenvatinib demonstrated considerable efficacy and tolerability as a treatment strategy for patients with advanced ICC.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.