Real-world treatment patterns and outcomes for patients with advanced hepatocellular carcinoma initially treated with PD-1 inhibitors.

BACKGROUND: Programmed cell death protein-1 (PD-1) inhibitors have shown promising clinical efficacy in treating advanced hepatocellular carcinoma (HCC). However, little evidence exists regarding their treatment patterns and outcomes in real-world practice in China. This study aimed to investigate real-world treatment patterns and outcomes of PD-1 inhibitors as first-line therapies for patients with advanced HCC in China. METHODS: The study population included adult patients with advanced HCC who were initially treated with PD-1 inhibitors from April 2020 to November 2022 in China. Descriptive statistics were used to report first-line treatment patterns and associations between patient characteristics and the most frequently used treatment patterns. The effectiveness of first-line treatment with PD-1 inhibitors was also evaluated according to survival and tumor response. RESULTS: The analyses enrolled 480 patients. The four most frequently used first-line treatment patterns of camrelizumab, tislelizumab, camrelizumab + TACE, and tislelizumab + TACE showed statistical differences in patient characteristics of gender, HBV infection, liver cirrhosis, BCLC stage, and portal vein tumor thrombus (all P < 0.05). However, there was no significant difference in median progression-free survival among the first-line treatments of tislelizumab, camrelizumab, and tislelizumab + TACE (not reached vs. 4.4 months vs. 3.6 months, P = 0.5178). The three groups had similar objective response rates (25.0 % vs. 28.6 % vs. 28.6 %, P = 0.927), and disease control rates (73.1 % vs. 78.6 % vs. 64.3 %, P = 0.573) with no statistical significance. CONCLUSIONS: Our findings provided insights into potential therapeutic strategies of PD-1 inhibitors in first-line settings for advanced HCC in real-world practice in China. It was recommended to consider patient characteristics associated with therapeutic options when making clinical decisions. Prospective randomized controlled studies with larger sample sizes and longer follow-up times were warranted further to verify the potential clinical benefits of PD-1 inhibitors.

Clinical and Economic Evaluation of Salvianolate Injection for Coronary Heart Disease: A Retrospective Study Based on National Health Insurance Data in China.

OBJECTIVE: The study aimed to conduct clinical and economic evaluation of salvianolate injection for patients with coronary heart disease (CHD) in comparison to Danhong injection and alprostadil injection. METHOD: This was a retrospective study using National Health Insurance Data about inpatients diagnosed with CHD in China in 2015 who met the inclusion criteria. The recruited patients were divided into two samples: surgery and non-surgery. The exposed group received salvianolate injection, while the control group received either alprostadil injection or Danhong injection. The medical cost per hospitalization, hospitalization duration, and the rehospitalization rates were used as outcome indicators. Heterogeneity was processed according to disease stratification. Propensity score matching and multivariate analysis were used for statistical analysis to control potential confounding factors. RESULTS: The hospitalization duration of salvianolate injection group was significantly (P < 0.05) shorter than that of Danhong injection group in the non-surgery sample. The hospitalization duration of salvianolate injection group was significantly (P < 0.05) shorter than those of alprostadil injection group in both surgery and non-surgery samples. In the non-surgery sample, the medical cost per hospitalization of salvianolate injection group was significantly (P < 0.05) lower than that of alprostadil injection group. However, there were no statistical differences of rehospitalization rates in salvianolate injection group versus alprostadil injection group or salvianolate injection group versus Danhong injection group in both surgery and non-surgery samples. CONCLUSION: Salvianolate injection showed advantages in reducing hospitalization duration for inpatients with CHD when comparing with alprostadil injection and Danhong injection. The results of this real-world study can help to inform clinical practice for CHD patients.