Prognostic Usefulness of Clinical Complete Response after PD-1 Inhibitor-Based Combination Therapy for Unresectable Hepatocellular Carcinoma (GUIDANCE006)

作者：Liang Ma, Dalong Yang, Teng-Meng Zhong, Qingqing Pang, Min Luo, Wenfeng Li, Yi-He Yan, Kang Chen, Guo-Dong Wang, Fuquan Yang, Yongrong Lai, Ming-Song Wu, Xiao-Feng Dong, Yongyu Yang, Ning Peng, Jun-Liang Nong, Ze Su, Yaqun Yu, Lin Ye, Fan-Jian Zeng, Shaoping Liu, Xueyao Wang, Hongbing Yao, Chuang Qin, Mian-Jing Li, Jie Liu, Yong-Rong Liang, Pei‐Sheng Wu, Fu-Xin Li, Shuchang Chen, Sicong Lu, Zhicheng Li, Zhen Liu, Pingping Guo, Li-Xin Pan, Jian‐Hong Zhong, on behalf of the GUIDANCE Investigators · 发表于：Liver Cancer · 年份：2025 · DOI：10.1159/000549844 · 被引用次数：3 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Cancer Immunotherapy and Biomarkers、Cholangiocarcinoma and Gallbladder Cancer Studies

Background: Outcomes of patients with unresectable hepatocellular carcinoma (HCC) who achieve clinical complete response (cCR) to PD-1 inhibitor-based combination therapy are unclear. This study aimed to explore whether cCR after combination therapy is an accurate and reliable prognostic indicator and to identify predictors of cCR and pathological complete response that could aid in managing patients with HCC. Methods: Data were analyzed retrospectively for 1,266 patients with initially unresectable HCC who received combination therapy involving PD-1 inhibitors and interventional therapy at 23 medical centers across China between 2019 and 2023. Survival was compared between patients who showed cCR or not after combination therapy, and subgroup analyses differentiated further between patients who experienced pathological complete response or not after combination therapy and patients who subsequently underwent curative hepatectomy or not. Results: Among all patients, 200 (15.8%) achieved cCR after combination therapy, and 360 (28.4%) underwent curative hepatectomy following combination therapy. Survival rates at 3 years were significantly higher among those who achieved cCR after combination therapy than those who did not, whether overall survival (82.4 vs. 35.9%; HR 0.15, 95% CI: 0.12-0.19) or progression-free survival (63.4 vs. 26.4%; HR 0.19, 95% CI: 0.16-0.23). Similar results were obtained with subsets of patients matched through propensity scoring based on baseline chara...