Yang H, Qiu GP, Liu J, Yang TQ. Drug-eluting beads chemoembolization combined with programmed cell death 1 inhibitor and lenvatinib for large hepatocellular carcinoma. World J Gastrointest Oncol 2024; 16(11): 4392-4401 [PMID: 39554745 DOI: 10.4251/wjgo.v16.i11.4392]
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Nov 15, 2024; 16(11): 4392-4401 Published online Nov 15, 2024. doi: 10.4251/wjgo.v16.i11.4392
Drug-eluting beads chemoembolization combined with programmed cell death 1 inhibitor and lenvatinib for large hepatocellular carcinoma
Hui Yang, Guang-Ping Qiu, Jie Liu, Tie-Quan Yang
Hui Yang, Guang-Ping Qiu, Jie Liu, Tie-Quan Yang, Department of Interventional Therapy, Ningbo No. 2 Hospital, Ningbo 315000, Zhejiang Province, China
Author contributions: Yang H contributed to the conceptualization, data curation, and writing - original draft; Qiu GP and Liu J participated in the investigation of this study; Qiu GP, Liu J, and Yang TQ took part in the writing - review & editing; Qiu GP contributed to the resources of this manuscript; Liu J was involved in the investigation of this study; Yang TQ contributed to the methodology and visualization.
Institutional review board statement: The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of Ningbo No. 2 Hospital (approval No: YJ-NBEY-KY-2024-004-01; date of approval: 2024-01-16).
Informed consent statement: The need for patient consent was waived due to the retrospective nature of the study which was approved by the Ethics Committee of Ningbo No. 2 Hospital.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data underlying the findings of this study are accessible upon request to the corresponding author, owing to privacy and ethical considerations that preclude their public dissemination.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: June 21, 2024 Revised: September 10, 2024 Accepted: September 24, 2024 Published online: November 15, 2024 Processing time: 125 Days and 21.7 Hours
Abstract
BACKGROUND
The combination of transarterial chemoembolization (TACE), lenvatinib, and programmed cell death 1 (PD-1) inhibitor has been widely used in the treatment of advanced hepatocellular carcinoma (HCC) and has achieved promising results. However, there are few studies comparing whether drug-eluting beads TACE (D-TACE) can bring more survival benefits to patients with large HCC compared to conventional TACE (C-TACE) in this triplet therapy.
AIM
To compare the efficacy and adverse events (AEs) of triple therapy comprising D-TACE, PD-1 inhibitors, and lenvatinib (D-TACE-P-L) and C-TACE, PD-1 inhibitors, and lenvatinib (C-TACE-P-L) in patients with large HCC (maximum diameter ≥ 5 cm), and analyze the prognostic factors.
METHODS
Following a comprehensive review of our hospital’s medical records, this retrospective study included 104 patients: 50 received D-TACE-P-L, and 54 received C-TACE-P-L. We employed Kaplan-Meier estimation to assess the median progression-free survival (PFS) between the two groups, utilized Cox multivariate regression analysis to identify prognostic factors, and applied the χ2 test to evaluate AEs.
RESULTS
The objective response rate (ORR) and median PFS were significantly higher in the D-TACE-P-L group compared to the C-TACE-P-L group (ORR: 66.0% vs 44.4%, P = 0.027; median PFS: 6.8 months vs 5.0 months, P = 0.041). Cox regression analysis identified treatment option, portal vein tumor thrombus, and hepatic vein invasion as protective factors for PFS. AEs were comparable between the two groups.
CONCLUSION
D-TACE-P-L may have significantly better PFS and ORR for large HCC, while exhibiting similar AEs to C-TACE-P-L.
Core Tip: A retrospective analysis encompassing 104 patients diagnosed with large hepatocellular carcinoma (≥ 5 cm), focused on comparing the efficacy and safety of two treatment modalities, which were the triple combination therapy of drug-eluting beads transarterial chemoembolization (D-TACE), programmed cell death 1 inhibitor, and lenvatinib (D-TACE-P-L) and the triple therapy consisting of conventional TACE, programmed cell death protein 1 inhibitor, and lenvatinib. Progression-free survival, tumor response, and adverse events were compared between the two groups, and the findings revealed that D-TACE-P-L demonstrated significantly superior median progression-free survival and objective response rate, while maintaining comparable toxicity profiles. Based on these outcomes, this study proposed that the D-TACE-P-L therapy served as a preferential treatment option for individuals suffering from large hepatocellular carcinoma.
