Efficacy and Safety of Transarterial Chemoembolization Combined with Lenvatinib Plus Programmed Death-1 Inhibitor for Hepatocellular Carcinoma with the Hepatic Vein and/or Inferior Vena Cava Tumor Thrombus.

IF 2.8 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

CardioVascular and Interventional Radiology Pub Date : 2024-12-10 DOI:10.1007/s00270-024-03919-2

Long-Wang Lin, Yu-Xia Nian, Xin Lin, Kun Ke, Wei-Zhu Yang, Jun-Qing Lin, Ning Huang

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引用次数: 0

Abstract

Purpose: The aim of this study was to assess the safety and effectiveness of transarterial chemoembolization (TACE) plus lenvatinib with a programmed death-1 (PD-1) inhibitor compared with TACE plus lenvatinib and TACE alone for hepatocellular carcinoma (HCC) with the hepatic vein and/or inferior vena cava tumor thrombus (HVTT and IVCTT).

Methods: Data on HCC accompanied by HVTT and IVCTT from June 2015 to August 2022 were analyzed in this single-center retrospective study. Drug-eluting bead TACE (DEB-TACE) or conventional TACE (cTACE) was used. The primary study outcomes were overall survival (OS) and progression-free survival (PFS). Univariate and multivariate Cox analyses were performed to determine the predictive factors for OS and PFS. A subgroup analysis was conducted.

Results: Overall, 214 patients were enrolled. Among them, 60 received triple therapy consisting of TACE, lenvatinib, and PD-1 inhibitors (TACE + L + P), 72 received dual therapy consisting of TACE and lenvatinib (TACE + L), and 82 received TACE alone. The TACE + L + P group (16.2; 95% confidence interval [CI]: 12.8-19.5 months) had a significantly longer median OS compared with the TACE + L group (11.2; 95% CI: 10.0-12.3 months) (P = 0.001) and the TACE group (8.3; 95% CI: 7.7-8.5 months) (P < 0.001); the TACE + L + P group (12.3; 95% CI: 10.9-13.7 months) had a significantly longer median PFS compared with the TACE + L group (8.5; 95% CI: 7.7-9.2 months) (P < 0.001) and the TACE group (6.2; 95% CI: 5.8 ~ 6.3 months) (P < 0.001). Multivariate Cox analysis demonstrated that treatment strategy was a significant factor for OS and PFS. Skin rash was more common in the triple therapy group and might be attributed to PD-1 ligand inhibitor therapy (33.33% vs. 16.66%, P = 0.026).

Conclusions: Triple therapy consisting of TACE plus lenvatinib with a PD-1 inhibitor showed promising efficacy for advanced HCC patients with HVTT and IVCTT, with manageable safety profiles.

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经动脉化疗栓塞联合Lenvatinib +程序性死亡-1抑制剂治疗肝静脉和/或下腔静脉肿瘤血栓的疗效和安全性

目的：本研究的目的是评估经动脉化疗栓塞（TACE）联合lenvatinib联合程序性死亡-1 （PD-1）抑制剂治疗伴有肝静脉和/或下腔静脉肿瘤血栓（HVTT和IVCTT）的肝细胞癌（HCC）的安全性和有效性，与TACE联合lenvatinib和TACE单独治疗相比。方法：对2015年6月至2022年8月HCC合并HVTT和IVCTT的数据进行单中心回顾性分析。采用药物洗脱头TACE （DEB-TACE）或常规TACE （cTACE）。主要研究结果是总生存期（OS）和无进展生存期（PFS）。进行单因素和多因素Cox分析以确定OS和PFS的预测因素。进行亚组分析。结果：总共有214名患者入组。其中，TACE、lenvatinib、PD-1抑制剂三联治疗（TACE + L + P） 60例，TACE + lenvatinib双治疗（TACE + L） 72例，TACE单独治疗82例。TACE + L + P组(16.2；95%可信区间[CI]: 12.8-19.5个月)的中位生存期明显长于TACE + L组(11.2；95% CI: 10.0-12.3个月)（P = 0.001）和TACE组(8.3；结论：TACE + lenvatinib + PD-1抑制剂的三联疗法对HVTT和IVCTT晚期HCC患者显示出良好的疗效，安全性可控。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

CardioVascular and Interventional Radiology 医学-核医学

CiteScore

5.50

自引率

13.80%

发文量

306

审稿时长

3-8 weeks

期刊介绍： CardioVascular and Interventional Radiology (CVIR) is the official journal of the Cardiovascular and Interventional Radiological Society of Europe, and is also the official organ of a number of additional distinguished national and international interventional radiological societies. CVIR publishes double blinded peer-reviewed original research work including clinical and laboratory investigations, technical notes, case reports, works in progress, and letters to the editor, as well as review articles, pictorial essays, editorials, and special invited submissions in the field of vascular and interventional radiology. Beside the communication of the latest research results in this field, it is also the aim of CVIR to support continuous medical education. Articles that are accepted for publication are done so with the understanding that they, or their substantive contents, have not been and will not be submitted to any other publication.