Immune-Related Adverse Events Are Associated With Improved Outcomes After Immune Checkpoint Inhibitor Treatment in Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis.

The prognostic value of immune-related adverse events (irAEs) in these patients remains controversial. We aimed to investigate the association between irAEs and clinical outcomes in patients with HCC treated with ICIs.

这些患者中免疫相关不良事件（irAEs）的预后价值仍然存在争议。我们的目标是研究irAEs与接受ICIs治疗的HCC患者临床结果之间的关联。

Methods

We searched the PubMed, Scopus, Web of Science, and Central Register of Controlled Trials databases for articles published from inception to June 2024, using keywords including ICI, HCC, and irAEs.

我们检索了PubMed、Scopus、Web of Science和对照试验注册中心数据库，搜索了从创刊至2024年6月发表的文章，使用的关键词包括ICI、HCC和irAEs。

Statistical analysis was performed with a random effects model.

统计分析采用随机效应模型进行。

Results

Of 3,028 studies, 24 (4,127 patients) met the criteria for inclusion.

在3,028项研究中，有24项（涉及4,127名患者）符合纳入标准。

Atezolizumab plus bevacizumab was the most common treatment regimen (n = 10 studies).

阿替利珠单抗联合贝伐珠单抗是最常见的治疗方案（n = 10项研究）。

IrAEs were associated with an increased objective response rate(pooled relative ratio: 1.73; 95% confidence interval[CI]: 1.36-2.21, I 2 = 41%), a higher disease control rate (pooled relative ratio: 1.45; 95% CI: 1.21-1.74, I 2 = 74%), and longer progression-free survival(pooled hazard ratio[HR]: 0.66; 95% CI: 0.52-0.84, I 2 = 71%).

与无免疫相关不良事件（irAEs）的患者相比，有irAEs的患者具有更高的客观缓解率（汇总相对比率：1.73；95%置信区间[CI]：1.36-2.21，I 2 = 41%），更高的疾病控制率（汇总相对比率：1.45；95% CI：1.21-1.74，I 2 = 74%），以及更长的无进展生存期（汇总风险比[HR]：0.66；95% CI：0.52-0.84，I 2 = 71%）。

There was a trend toward longer overall survivalfor patients with irAEs compared with those without (pooled HR: 0.84; 95% CI: 0.63-1.12, I 2 = 73%).

与无irAEs的患者相比，有irAEs的患者总生存期有延长的趋势（汇总HR：0.84；95% CI：0.63-1.12，I 2 = 73%）。

Subgroup analysis indicated a survival benefit for patients with grade 1-2 irAEs (pooled HR: 0.50; 95% CI: 0.36-0.67, I 2 = 0%) and for those with endocrine irAEs (pooled HR: 0.63; 95% CI: 0.48-0.83, I 2 = 12%).

亚组分析显示，1-2级irAEs患者（汇总HR：0.50；95%置信区间：0.36-0.67，I 2 = 0%）和内分泌irAEs患者（汇总HR：0.63；95%置信区间：0.48-0.83，I 2 = 12%）的生存率有所提高。

Discussion

The development of irAEs is associated with favorable clinical outcomes in HCC, including improved progression-free survivaland higher objective response rate.

irAEs的发展与HCC中良好的临床结果相关，包括改善的无进展生存期和更高的客观缓解率。

Overall survivalbenefit was noted in patients with mild irAEs but not those with severe irAEs.

在出现轻度免疫相关不良事件（irAEs）的患者中观察到总生存获益，但在出现重度irAEs的患者中则没有观察到。