Cancer Res Treat.  2024 Oct;56(4):1207-1218. 10.4143/crt.2023.1165.

Efficacy of Lenvatinib Combined with Anti–PD-1 Antibodies Plus Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma with Portal Vein Tumor Thrombus: A Retrospective, Multicenter Study

• Ou X
• Wu J
• Wu J
• Fu Y
• Zeng Z
• Li S
• Li Y
• Liu D
• Li H
• Li B
• Zhou J
• Zhuang S
• Cheng S
• Zhang Z
• Wang K
• Qu S
• Yan M

• KMID: 2560254
• DOI: http://doi.org/10.4143/crt.2023.1165

Abstract

Purpose
The prognosis of patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT) is extremely poor, and systemic therapy is currently the mainstream treatment. This study aimed to assess the efficacy and safety of lenvatinib combined with anti–programmed cell death-1 antibodies and transcatheter arterial chemoembolization (triple therapy) in patients with HCC and PVTT.
Materials and Methods
This retrospective multicenter study included patients with HCC and PVTT who received triple therapy, were aged between 18 and 75 years, classified as Child-Pugh class A or B, and had at least one measurable lesion. The overall survival (OS), progression-free survival (PFS), objective response rates, and disease control rates were analyzed to assess efficacy. Treatment-related adverse events were analyzed to assess safety profiles.
Results
During a median follow-up of 11.23 months (range, 3.07 to 34.37 months), the median OS was greater than 24 months, and median PFS was 12.53 months. The 2-year OS rate was 54.9%. The objective response rate and disease control rate were 69.8% (74/106) and 84.0% (89/106), respectively; 20.8% (22/106) of the patients experienced grade 3/4 treatment-related adverse events and no treatment-related deaths occurred. The conversion rate to liver resection was 31.1% (33/106), with manageable postoperative complications. The median OS was not reached in the surgery group, but was 19.08 months in the non-surgery group. The median PFS in the surgery and non-surgery groups were 20.50 and 9.00 months, respectively.
Conclusion
Triple therapy showed promising survival benefits and high response rates in patients with HCC and PVTT, with manageable adverse effects.

Keyword

Hepatocellular carcinoma; Immunotherapy; Tyrosine kinase inhibitors; Triple therapy; Conversion therapy

Figure

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  Fig. 1. Flowchart of patient selection. ECOG PS, Eastern Cooperative Oncology Group performance status; HCC, hepatocellular carcinoma; PVTT, portal vein tumor thrombus.

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  Fig. 2. Kaplan-Meier estimates of overall survival (OS) (A) and progression-free survival (PFS) (B).

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  Fig. 3. Kaplan-Meier estimates of overall survival (OS) (A) and progression-free survival (PFS) (B) in surgery group and non-surgery group.

Reference

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