Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Nov 25:11:2309-2320.
doi: 10.2147/JHC.S485047. eCollection 2024.

Efficacy and Safety of Lenvatinib Plus Programmed Death-1 Inhibitors with or Without Transarterial Chemoembolization in the Treatment of Unresectable Hepatocellular Carcinoma

Ming Jin #  1 , Zhi-Qing Jiang #  2 , Jia-Hui Qin #  3 , Hui-Xia Qin #  4 , Kai-Wen Jiang #  3 , Hou-Xiang Ya  3 , Jing Gu  3 , Mo-Rui Gui  5 , Yao-Hua Li  3 , Long-Kuan Xu  6 , Hai-Xiao Fu  6 , Xu-Hua Xiao  7 , Shu-Qun Li  3
Affiliations

Efficacy and Safety of Lenvatinib Plus Programmed Death-1 Inhibitors with or Without Transarterial Chemoembolization in the Treatment of Unresectable Hepatocellular Carcinoma

Ming Jin et al. J Hepatocell Carcinoma. .

Abstract

Purpose: Transarterial chemoembolization (TACE) is recommended as a standard therapy for intermediate-stage hepatocellular carcinoma (HCC) and is the most widely used first-line treatment for advanced HCC. This study aimed to evaluate the clinical benefits and tolerability of TACE added to a combination of lenvatinib and programmed death-1 (PD-1) inhibitor in patients with unresectable HCC (uHCC).

Patients and methods: We conducted a retrospective cohort study involving 144 patients with uHCC treated between August 2020 and August 2023. Patients received a combination of lenvatinib and a PD-1 inhibitor with or without TACE (T+L+P, n=81 or L+P, n=63, respectively). The baseline characteristics of the two groups were compared, and propensity score matching (PSM) was used to minimize bias. The study endpoints included overall survival (OS), progression-free survival (PFS), and objective response rate (ORR). Factors influencing survival rates were analyzed using Cox regression, and adverse events (AEs) were documented and assessed.

Results: Before PSM, the T+L+P group showed significantly higher ORR (64.1% vs 44.4%, p < 0.05), longer median PFS (14.3 vs 9.6 months, p < 0.05), and longer median OS (24.6 vs 19.5 months, p < 0.05) compared to the L+P group. Even post-PSM, the T+L+P group showed significantly better OS and PFS compared to the L+P group (mOS: 28.0 vs 17.6 months p=0.0011, mPFS: 15.8 vs 9.3 months, p < 0.05). Univariate and multivariate analyses identified treatment options as independent factors for PFS and OS. The safety profile of the T+L+P regimen was acceptableThe incidence and severity of adverse reactions in the T+L+P group were not significantly different compared to the L+P group (any grade, 90.1 vs 93.6%, p=0.551; grade≥3, 25.9 vs 23.8%, p=0.843).

Keywords: PD-1 inhibitor; combination therapy; lenvatinib; propensity score matching; transarterial chemoembolization; unresectable hepatocellular carcinoma.

PubMed Disclaimer

Conflict of interest statement

The authors declare that there is no conflict of interest in the research and publication of this article.

Figures

Figure 1
Figure 1
Flow chart of eligible patients enrolled.
Figure 2
Figure 2
Kaplan-Meier curves for overall survival (A) and progression-free survival before PSM (B) therapy.
Figure 3
Figure 3
Kaplan-Meier curves for overall survival (A) and progression-free survival after PSM (B) therapy.
See this image and copyright information in PMC

References

    1. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incide- nce and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229–263. doi:10.3322/caac.21834 - DOI - PubMed
    1. Villanueva A. Hepatocellular carcinoma. N Engl J Med. 2019;380:1450–1462. doi:10.1056/NEJMra1713263 - DOI - PubMed
    1. Llovet JM, Zucman-Rossi J, Pikarsky E, et al. Hepatocellular carcinoma. Nat Rev Dis Primers. 2016;2:16018. doi:10.1038/nrdp.2016.18 - DOI - PubMed
    1. Benson AB, D’Angelica MI, Abbott DE, et al. Hepatobiliary cancers, version 2.2021, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2021;19(5):541–565. doi:10.6004/jnccn.2021.0022 - DOI - PubMed
    1. Chen J, Shen T, Li J, et al. Clinical practice guideline on liver transplantation for hepatocellular carcinoma in China (2021 edition). Chin Med J. 2022;135(24):2911–2913. (). doi:10.1097/CM9.0000000000002515 - DOI - PMC - PubMed

LinkOut - more resources