Abstract:

Objective

To evaluate the safety and efficacy of transarterial chemoembolization （TACE）combined with lenvatinib and immune checkpoint inhibitors （TACE-L-ICIs） for uHCC.

Methods

Between June 2019 and March 2024， 75 patients were included in the retrospective analysis； 37 patients received TACE-L-ICIs treatment， and 38 received TACE combined with lenvatinib （TACE-L）.Overall survival （OS），progression-free survival （PFS）， adverse events （AEs）， and tumor response rates were compared between the two groups.

Results

The median OS in the TACE-L-ICIs group and the TACE-L group was 27.1 months and 18.2 months， respectively （P=0.147， HR=0.67， 95%CI=0.39-1.15）.However， Landmark survival analysis revealed a statistically significant difference in OS （P=0.020）.The median PFS was 14.3 months in the TACE-L-ICIs group compared to 7.6 months in the TACE-L group （P=0.023， HR=0.57， 95%CI=0.34-0.64）.The objective response rates （ORR） in the two groups were 67.3% and 42.1% （P=0.037）， respectively.The incidence rates of grade 3/4 adverse reactions in the TACE-L-ICIs group and the TACE-L group were 18.4%and 13.2% （P=0.754）， respectively.

Conclusion

Compared with TACE combined with lenvatinib， TACE combined with lenvatinib and immune checkpoint inhibitors for uHCC provides improved clinical benefits and acceptable safety.

Key words: Transarterial chemoembolization, Lenvatinib, Immune checkpoint inhibitors, Unresectable hepatocellular carcinoma