Transarterial Chemoembolization Combined With Lenvatinib Plus PD-1 Inhibitor for Advanced Hepatocellular Carcinoma: A Retrospective Cohort Study

Mingyue Cai; Wensou Huang; Jingjun Huang; Wenbo Shi; Yongjian Guo; Licong Liang; Jingwen Zhou; Liteng Lin; Bihui Cao; Ye Chen; Juan Zhou; Kangshun Zhu

doi:10.3389/fimmu.2022.848387

Transarterial Chemoembolization Combined With Lenvatinib Plus PD-1 Inhibitor for Advanced Hepatocellular Carcinoma: A Retrospective Cohort Study

Front Immunol. 2022 Mar 1:13:848387. doi: 10.3389/fimmu.2022.848387. eCollection 2022.

Authors

Mingyue Cai^{1

2}, Wensou Huang^{1

2}, Jingjun Huang^{1

2}, Wenbo Shi^{1

2}, Yongjian Guo^{1

2}, Licong Liang^{1

2}, Jingwen Zhou^{1

2}, Liteng Lin^{1

2}, Bihui Cao^{1

2}, Ye Chen^{1

2}, Juan Zhou³, Kangshun Zhu^{1

2}

Affiliations

¹ Department of Minimally Invasive Interventional Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
² Radiology Center, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
³ Department of Pharmacy, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

Abstract

Purpose: To investigate the efficacy and safety of transarterial chemoembolization (TACE) combined with lenvatinib plus PD-1 inhibitor (TACE-L-P) versus TACE combined with lenvatinib (TACE-L) for patients with advanced hepatocellular carcinoma (HCC).

Materials and methods: Data of advanced HCC patients treated with TACE-L-P (TACE-L-P group) or TACE-L (TACE-L group) from January 2019 to December 2020 were prospectively collected and retrospectively analyzed. The differences in overall survival (OS), progression-free survival (PFS), tumor responses (based on modified Response Evaluation Criteria in Solid Tumors) and adverse events (AEs) were compared between the two groups. Potential factors affecting OS and PFS were determined.

Results: A total of 81 patients were included in this study. Among them, 41 received TACE-L-P and 40 received TACE-L. The patients in TACE-L-P group had prolonged OS (median, 16.9 vs. 12.1 months, P=0.009), longer PFS (median, 7.3 vs. 4.0 months, P=0.002) and higher objective response rate (56.1% vs. 32.5%, P=0.033) and disease control rate (85.4% vs. 62.5%, P=0.019) than those in TACE-L group. Multivariate analyses revealed that the treatment option of TACE-L, main portal vein invasion and extrahepatic metastasis were the independent risk factors for OS, while TACE-L and extrahepatic metastasis were the independent risk factors for PFS. In subgroup analyses, a superior survival benefit was achieved with TACE-L-P in patients with extrahepatic metastasis or tumor number >3 but not in those with main portal vein invasion. The incidence and severity of AEs in TACE-L-P group were comparable to those in TACE-L group (any grade, 92.7% vs. 95.0%, P=1.000; grade 3, 36.6% vs. 32.5%, P=0.699).

Conclusion: TACE-L-P significantly improved survival over TACE-L with an acceptable safety profile in advanced HCC patients, especially those with extrahepatic metastasis or tumor number >3 but without main portal vein invasion.

Keywords: PD-1 inhibitor; combined therapy; hepatocellular carcinoma; immune checkpoint inhibitor; lenvatinib; transarterial chemoembolization.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Carcinoma, Hepatocellular* / pathology
Chemoembolization, Therapeutic* / adverse effects
Humans
Immune Checkpoint Inhibitors
Liver Neoplasms* / pathology
Phenylurea Compounds
Quinolines
Retrospective Studies
Treatment Outcome

Substances

Immune Checkpoint Inhibitors
Phenylurea Compounds
Quinolines
lenvatinib