Liver International最新文献

{"title":"Temporal Differentiation of Nonperipheral Washout Refines Prognostic Stratification in HCC.","authors":"Yingyi Wu, Junhan Pan, Ting Yang, Hong Wei, Guzalinu Wufuer, Tianyi Xia, Yuanan Wu, Yanyan Zhang, Hui-Chuan Sun, Shenghong Ju, Feng Chen, Maxime Ronot, Bin Song, Hanyu Jiang, Yanshu Wang","doi":"10.1111/liv.70838","DOIUrl":"10.1111/liv.70838","url":null,"abstract":"<p><strong>Background and aims: </strong>Nonperipheral washout is a major imaging feature of hepatocellular carcinoma (HCC) with prognostic value, but whether its temporal differentiation can refine prognostic stratification remains understudied. This study aimed to investigate the prognostic implications of nonperipheral washout timing in HCC.</p><p><strong>Methods: </strong>This multicentre, retrospective cohort study included patients who underwent curative resection for single BCLC stage 0/A HCC and preoperative extracellular contrast agent-enhanced MRI at seven tertiary centres (March 2011 to April 2023). Three masked radiologists independently evaluated nonperipheral washout patterns, which were classified as early (present in the portal venous phase), late (present only in the delayed phase), or absent. Early recurrence-free survival (eRFS; ≤ 2 years) and 5-year RFS were assessed using Kaplan-Meier and Cox regression analyses.</p><p><strong>Results: </strong>A total of 611 patients (median age, 55 years; 520 men) were included. Early, late, and no washout were observed in 367 (60.1%), 95 (15.5%), and 149 (24.4%) patients, respectively. Inter- and intra-reader agreements were substantial to excellent (κ range, 0.67-0.94). Early washout was associated with microvascular invasion (p = 0.01) and Edmondson-Steiner G3/4 (p = 0.002). The eRFS rates were 67.3%, 82.1%, and 85.2% for the early, late, and no-washout groups (p < 0.001); the 5-year RFS rates were 53.4%, 62.1%, and 71.8% (p = 0.002). In multivariable Cox analysis adjusting for factors, early washout independently predicted eRFS (HR, 1.86; p < 0.001) and 5-year RFS (HR, 1.46; p = 0.006).</p><p><strong>Conclusions: </strong>In patients undergoing curative resection for single BCLC 0/A HCC, temporal differentiation of nonperipheral washout refines prognostic stratification, with early washout identifying patients at higher risk of recurrence.</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 9","pages":"e70838"},"PeriodicalIF":6.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13507576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Naltrexone Is Superior to Placebo for Abstinence and Craving Reduction in Alcohol-Associated Cirrhosis: NAL-CI Trial.","authors":"Manasa Alla, Mohit Varshney, Ankit Bhardwaj, Guresh Kumar, S M Shasthry, Shiv Kumar Sarin","doi":"10.1111/liv.70845","DOIUrl":"10.1111/liv.70845","url":null,"abstract":"<p><strong>Background and aims: </strong>Alcohol use disorder (AUD) coexisting with cirrhosis carries high morbidity and mortality, with no approved pharmacotherapy for AUD. We evaluated the safety and efficacy of naltrexone, an opioid receptor antagonist, in patients with compensated alcohol-associated cirrhosis (AaC) and AUD.</p><p><strong>Methods: </strong>One hundred patients with compensated AaC and DSM-5 AUD were randomised 1:1 to naltrexone (50 mg/day) or placebo for 12 weeks. The primary endpoint was point-prevalence abstinence at 12 weeks, defined as no alcohol use in the four preceding weeks. Secondary endpoints included craving (Obsessive Compulsive Drinking Scale [OCDS]-Obsessive and Compulsive subscales), lapses, relapses, and hepatic safety. Standardised psychosocial support was provided to both arms.</p><p><strong>Results: </strong>Baseline characteristics were well matched between groups (mean MELD 12.6 vs. 12.7; CTP score 5.9 vs. 6.2; age 42.9 vs. 44.3 years). AUDIT and OCDS scores were comparable between groups. Abstinence at 12 weeks was significantly higher with naltrexone: 64% (32/50) versus 22% (11/50), p < 0.001; OR 10.86 (95% CI: 1.89-62.2). Naltrexone significantly reduced lapses at 3 months (28% vs. 54%, p = 0.008) and showed a trend toward fewer heavy-drinking relapses (12% vs. 28%, p = 0.07). Maintenance of abstinence at 6 months favoured naltrexone (22% vs. 8%, p = 0.09). No patient developed hepatic decompensation attributable to study medication, and no AST/ALT elevation exceeding 5× ULN was observed in either group. Mean craving scores were lower with naltrexone by week 12 than with placebo: OCDS-O score (6.63 ± 1.16 vs. 9.29 ± 1.78, p < 0.01) and OCDS-C score (6.35 ± 1.23 vs. 9.02 ± 1.86, p < 0.01). Adverse events were comparable between the groups.</p><p><strong>Conclusion: </strong>Naltrexone is safe and effective in patients with compensated alcohol-associated cirrhosis, achieving a threefold higher abstinence rate and significantly reducing craving compared with placebo. These findings support the use of naltrexone as a pharmacological option in patients with compensated AaC and AUD.</p><p><strong>Trial registration: </strong>NCT04391764.</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 9","pages":"e70845"},"PeriodicalIF":6.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptability and Effectiveness of Point-of-Care HCV Testing in Low- and Middle-Income Countries: A Systematic Review.","authors":"Win Lei Yee, Thin Mar Win, Bridget Draper, Minh Duc Pham, Margaret Hellard, Stanley Luchters","doi":"10.1111/liv.70844","DOIUrl":"10.1111/liv.70844","url":null,"abstract":"<p><p>Hepatitis C virus (HCV) diagnosis in low- and middle-income countries (LMICs) relies on costly and technically demanding centralized laboratory services. This review aims to synthesize evidence on Point-of-Care (POC) HCV testing in LMICs to inform scale-up for HCV elimination. We searched Medline, Embase, PsycINFO, and the Cochrane Library for studies on decentralized POC HCV testing in LMICs between 2010 and 2022. Two reviewers independently conducted eligibility assessment and full text review. Testing uptake and linkage data were extracted using Excel, then descriptively synthesized to identify common patterns. Our systematic review identified 2018 reports of which 1603 underwent title and abstract screening. Among them, 58 met the eligibility criteria, but only 20 reports proceeded to data extraction. Of these, 16 examined feasibility and effectiveness, showing high testing uptake and linkage to care. In the 11 reports where services provided onsite testing and/or treatment, uptake of testing and/or treatment exceeded 90%. Four studies assessed HCV self-testing among high-risk populations and showed high acceptability (91%-99%). Studies evaluating oral-based self-testing among high-risk populations reported higher recommendation rates (94%-99%) compared to that of blood-based testing (86.1%). Our findings suggest that decentralized HCV testing and care models likely improve testing uptake and treatment success in LMICs, given the high rates of retention in care and cure.</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 9","pages":"e70844"},"PeriodicalIF":6.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13486615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cirrhosis Risk in Sarcoidosis Without Documented Hepatic Involvement-A Large Nationwide Population-Based Cohort Study.","authors":"Uria Shani, Yana Davidov, Ehud Zigmond, Tomer Ben-Ami, Ohad Regev, Arnon D Cohen, Howard Amital, Niv Ben-Shabat","doi":"10.1111/liv.70849","DOIUrl":"10.1111/liv.70849","url":null,"abstract":"<p><strong>Background & aims: </strong>Given the likely underestimation of hepatic sarcoidosis, the aims were to evaluate long-term cirrhosis risk in patients with sarcoidosis without documented hepatic involvement at baseline and to assess the impact of multi-organ disease and immunomodulatory therapies on cirrhosis risk.</p><p><strong>Methods: </strong>A retrospective cohort study using the Clalit Health Services database in Israel included adults with sarcoidosis without documented hepatic involvement or prevalent cirrhosis and age- and sex-matched controls. The primary outcome was incident cirrhosis, analysed with inverse-probability-of-treatment-weighted (IPTW) Fine-Gray modelling with death as a competing risk. Secondary analyses evaluated multi-organ involvement using landmark methods and immunomodulatory therapies as time-varying exposures.</p><p><strong>Results: </strong>Among 5489 sarcoidosis patients and 6016 controls (142 002 person-years), cirrhosis occurred in 112 (2.0%) and 38 (0.6%), respectively (incidence rate 1.61 vs. 0.53 per 1000 person-years; rate ratio 3.05). In the primary IPTW-weighted Fine-Gray analysis, sarcoidosis was associated with incident cirrhosis (subdistribution hazard ratio [sHR] 2.84, 95% confidence interval [CI] 1.97-4.11, p < 0.001); the weighted 20-year cumulative incidence was 2.8% versus 1.1%. The association was consistent across IPTW-weighted cause-specific, covariate-adjusted and follow-up-truncated analyses (hazard ratio [HR]/sHR range 2.71-2.84). Among patients with confirmed organ involvement, 1057 had single-organ and 87 had multi-organ disease. In the 5-year landmark analysis (n = 940; 18 events), multi-organ involvement was associated with cirrhosis in the parsimonious model (HR 5.33, 95% CI 1.90-15.00, p = 0.002). No immunomodulatory therapy was significantly associated with cirrhosis.</p><p><strong>Conclusions: </strong>Sarcoidosis was independently associated with increased cirrhosis risk despite no hepatic involvement, particularly in multiorgan disease. This supports a risk-stratified spectrum from heightened clinical awareness to closer hepatic surveillance in selected patients.</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 9","pages":"e70849"},"PeriodicalIF":6.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13499023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to ‘FOLFOX Versus FOLFIRI as Second-Line Chemotherapy in Patients With Advanced Biliary Tract Cancers: A Multicenter, Italian Study’","authors":"","doi":"10.1111/liv.70854","DOIUrl":"10.1111/liv.70854","url":null,"abstract":"<p>\u0000 <span>C. Pircher</span>, <span>F. Nichetti</span>, <span>M. D. Rizzato</span>, et al., “ <span>FOLFOX Versus FOLFIRI as Second-Line Chemotherapy in Patients With Advanced Biliary Tract Cancers: A Multicenter, Italian Study</span>,” <i>Liver International</i> <span>46</span>, no. <span>2</span> (<span>2026</span>): e70502, https://doi.org/10.1111/liv.70502.\u0000 </p><p>In the originally published article, Silvia Bozzarelli's affiliation is incorrect.</p><p>Her correct affiliation is Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.</p><p>We apologize for this error.</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 10","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Five Years of HCV Dried Blood Spot Testing in At-Risk Populations and the Impact of Reduced Sensitivity on Missed Diagnoses","authors":"Nicolas Capelli,&nbsp;Amandine Pisoni,&nbsp;Fadi Meroueh,&nbsp;Anne-Marie Mondain,&nbsp;Patrick Pastor,&nbsp;Philippe Van de Perre,&nbsp;Ilka Engelmann,&nbsp;Edouard Tuaillon","doi":"10.1111/liv.70853","DOIUrl":"https://doi.org/10.1111/liv.70853","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background &amp; Aims</h3>\u0000 \u0000 <p>Achieving HCV elimination requires diagnostic strategies capable of reaching underserved populations who remain poorly accessed by conventional healthcare pathways. Dried blood spot (DBS) sampling enables decentralised testing, but concerns remain regarding its analytical sensitivity and the potential risk of missed diagnoses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a 5 year real-world implementation study of DBS-based HCV screening in France (2020–2024). DBS samples were collected in harm reduction centers and other community-based facilities and sent to Montpellier University Hospital for centralised analysis. We evaluated the diagnostic yield of DBS in routine practice and estimated the potential number of missed cases by comparing the DBS detection threshold with the distribution of plasma HCV RNA levels observed at diagnosis in untreated individuals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The limit of detection (LOD) for HCV RNA on DBS was 1252 IU/mL, with a systematic underestimation compared with plasma measurements (mean bias −2.29 log₁₀ IU/mL). Among 1552 individuals tested using DBS, 428 (27.6%) were HCV RNA positive, including five cases with no detectable HCV antibodies. DBS testing accounted for 56.4% of all HCV infections identified in our laboratory during the study period. Based on plasma viral load distributions at diagnosis, 2.7% of infections, corresponding to approximately 12 additional cases, were estimated to be missed due to low HCV RNA levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite a modest reduction in analytical sensitivity compared with plasma-based testing, the substantial public health benefits associated with increased testing coverage strongly outweigh this limitation and support the integration of DBS into HCV elimination strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 10","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70853","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148823294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"E3 Ubiquitin Ligases in MASH-Associated Liver Fibrosis: Mechanisms and Therapeutic Opportunities","authors":"Ah-Reum Oh,&nbsp;Yelin Jeong,&nbsp;Young Hoon Jung,&nbsp;Young Un Kim,&nbsp;HyunJoon Gi,&nbsp;Do-Wan Kim,&nbsp;Young Du Choi,&nbsp;Sang Bae Lee,&nbsp;KyeongJin Kim","doi":"10.1111/liv.70850","DOIUrl":"https://doi.org/10.1111/liv.70850","url":null,"abstract":"<p>Metabolic dysfunction-associated steatohepatitis (MASH) is a major cause of progressive liver fibrosis and can ultimately lead to cirrhosis and hepatocellular carcinoma (HCC). MASH-associated liver fibrosis develops through a complex interplay among lipotoxic hepatocyte injury, oxidative and endoplasmic reticulum stress, inflammatory macrophage activation, hepatic stellate cell (HSC) activation and excessive extracellular matrix (ECM) deposition. E3 ubiquitin ligases, which determine substrate specificity within the ubiquitin-proteasome system, have emerged as important regulators of these processes. By controlling protein stability, signalling complex formation, inflammatory responses, cellular stress, autophagy, ferroptosis and intercellular communication, E3 ubiquitin ligases can influence both fibrosis progression and resolution. Because E3 ubiquitin ligases may exert pro-fibrotic or anti-fibrotic effects depending on the substrate, cell types, metabolic environment and disease stage, their therapeutic targeting requires disease- and cell type-specific strategies. In this review, we summarize the roles of E3 ubiquitin ligases in MASH-related liver fibrosis, with a particular focus on their functions in hepatocytes, HSCs, macrophages and other liver-resident cells. We also discuss emerging therapeutic approaches, including direct modulation of E3 ubiquitin ligase, proteolysis-targeting chimeras (PROTACs), molecular glues and cell type-specific delivery platforms.</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 10","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70850","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148823283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Colonisation of the Gut May Explain the Cirrhosis Virome Signature","authors":"Christos Zavos","doi":"10.1111/liv.70857","DOIUrl":"https://doi.org/10.1111/liv.70857","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 10","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148823318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Burnt-Out MASLD Mark Loss of Hepatic Lipid-Buffering Capacity?","authors":"Nobuyuki Toshikuni","doi":"10.1111/liv.70855","DOIUrl":"https://doi.org/10.1111/liv.70855","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 10","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148823319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of PD-1 Inhibitor Timing Relative to Locoregional Therapy on Outcomes in uHCC Treated With Lenvatinib-Based Triple Therapy","authors":"Jian He,&nbsp;Jian Chen,&nbsp;Bohua Yu,&nbsp;Fuqun Wei,&nbsp;Weifu Liu,&nbsp;Peishu Huang,&nbsp;Songhui Wu,&nbsp;Xiang You,&nbsp;Zhisheng Chen,&nbsp;Ziqi Lin,&nbsp;Wuhua Guo,&nbsp;Shaowu Zhuang,&nbsp;Yiping Chen,&nbsp;Zhongwu Chen","doi":"10.1111/liv.70847","DOIUrl":"https://doi.org/10.1111/liv.70847","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>The optimal sequencing of programmed cell death protein 1 (PD-1) inhibitors relative to locoregional therapy (LRT) in unresectable hepatocellular carcinoma (uHCC) remains undefined. This study evaluated the impact of PD-1 inhibitor timing on outcomes in patients receiving hepatic arterial infusion chemotherapy (HAIC) or transarterial chemoembolisation (TACE) plus lenvatinib and PD-1 inhibitors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with initially uHCC who received LRT in combination with lenvatinib and PD-1 inhibitors across six academic centres were stratified by LRT modality (HAIC vs. TACE) and categorised into two groups based on PD-1 inhibitor timing (Pre-LRT PD-1 and Post-LRT PD-1 group). Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan–Meier method; propensity score matching (PSM) and landmark analyses were applied to mitigate potential biases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 350 patients were included, with 185 in the HAIC cohort and 165 in the TACE cohort. Pre-LRT PD-1 group was associated with significantly improved OS in the overall population, driven primarily by the HAIC cohort rather than the TACE cohort (34.03 m vs. 30.6 m, <i>p</i> = 0.032); these findings remained consistent after PSM and landmark analyses. Subgroup analyses further supported the survival benefit of Pre-LRT PD-1 initiation. After PSM, Pre-LRT PD-1 was also associated with significantly prolonged PFS in the HAIC cohort. According to RECIST 1.1 criteria, the Pre-LRT PD-1 group showed a higher objective response rate (ORR) (<i>p</i> = 0.002).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In patients with uHCC receiving HAIC combined with lenvatinib and PD-1 inhibitors, initiation of PD-1 inhibitors prior to HAIC is associated with superior survival outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 10","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70847","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148823320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}