Clinical practice of precision medicine in patients with postoperative refractory recurrent hepatobiliary tumor

Abstract

Objective To summarize the preliminary clinical outcomes of combination therapy with molecular targeted agents/immunological agents and to explore the potential value of multidisciplinary therapy in the treatment of postoperative refractory recurrent hepatobiliary tumor. Methods 52 cases of postoperative refractory recurrent hepatobiliary tumor during June 2016 to January 2019 from outpatient and inpatient departments at the First Medical Center of PLA General Hospital were prospectively collected, including 37 males and 15 females, with a mean age of (56.2 ± 8.5) years. Referring to the results of next-generation sequencing (NGS) and other-omics, we designed individualized therapy options for each patient. Follow-ups were done regularly and tumor responses were assessed by modified response evaluation criteria in solid tumors (mRECIST). Results Of 52 patients, median follow-up was 10 months (range 3–31 months). 14(26.9%) patients achieved a complete response (CR). 8(15.3%) patients achieved a partial response (PR). 14(26.9%) patients had stable disease(SD). 16(30.8%, including 4 deaths) had progressive disease (PD). Objective response rate and disease control rate were 42.3% (22/52) and 69.2% (36/52), respectively. The median progression-free survival (PFS) was 7 months. 6- and 12- month overall survival rates were 100%(48/48), 87.5%(21/24), respectively. Conclusions Precision medicine has good gui-dance on the treatment of refractory recurrence of hepatobiliary tumors. The combination therapy of multi-target tyrosine kinase inhibitors and immune checkpoint inhibitors may achieve better disease control and deserve further promotion in clinical application. Key words: Liver neoplasms; Gallbladder neoplasms; Recurrence; Precision medicine