SSRI Antidepressant Fluoxetine Improving Immunotherapy Efficacy in Advanced Hepatobiliary Malignancy Patients With Depression and Anxiety

Inclusion Criteria

• •Age: 18 to 80 years old, both male and female are acceptable.
• •The histopathological/cytological diagnosis is hepatocellular carcinoma or cholangiocarcinoma. Hepatocellular carcinoma can be diagnosed by imaging.
• •Patients with metastatic advanced or locally advanced liver and gallbladder malignancies;
• •No treatment has been received and a first-line treatment regimen including PD-1 inhibitors /PD-L1 inhibitors is planned to be carried out;
• •Patients with a PHQ-9 score of ≥10 or a GAD-7 score of ≥8, that is, those with positive screening for depression or anxiety;
• •At least one lesion measurable by CT or MRI (with a maximum diameter of ≥0.5cm);
• •ECOG: 0-2;
• •Child-Pugh score ≤7 points;
• •The expected survival period is ≥12 weeks.
• •Baseline blood cell count tests and blood biochemistry must meet the following standards:1) White blood cell count ≥3.0×10\^9/L; Hemoglobin ≥90 g/L;2) Absolute neutrophil count ≥1.5×10\^9/L;3) Platelet count ≥100×10\^9/L;4) Alanine aminotransferase (ALT), aspartate aminotransferase (AST) ≤ 2.5 times the upper limit of the normal upper limit (ULN);5) Total bilirubin ≤ twice ULN;6) Serum creatinine ≤ 1.5 times ULN; Albumin ≥30 g/L;
• •The subjects voluntarily joined this study, signed the informed consent form, had good compliance and cooperated with the follow-up.