Liu S, Liu YH, Ni HB, Li JJ, Wu ZT, Wang LL, Ruan Y, Zhou XH. Transarterial chemoembolization plus lenvatinib with or without protein-1 inhibitor for hepatocellular carcinoma with portal vein tumor thrombus. World J Clin Oncol 2025; 16(6): 106798 [PMID: 40585829 DOI: 10.5306/wjco.v16.i6.106798]
Corresponding Author of This Article
Xin-Hua Zhou, Chief Physician, Professor, Department of Hepatobiliary and Pancreatic Surgery, Li Huili Hospital Affiliated to Ningbo University, No. 1111 Jiangnan Road, Yinzhou District, Ningbo 315000, Zhejiang Province, China. zhouxinhua1002@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
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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/
Jun 24, 2025 (publication date) through Mar 1, 2026
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Journal Information of This Article
Publication Name
World Journal of Clinical Oncology
ISSN
2218-4333
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Liu S, Liu YH, Ni HB, Li JJ, Wu ZT, Wang LL, Ruan Y, Zhou XH. Transarterial chemoembolization plus lenvatinib with or without protein-1 inhibitor for hepatocellular carcinoma with portal vein tumor thrombus. World J Clin Oncol 2025; 16(6): 106798 [PMID: 40585829 DOI: 10.5306/wjco.v16.i6.106798]
Shuai Liu, Yao-Hui Liu, Hong-Bo Ni, Jia-Jian Li, Ze-Tao Wu, Luo-Luo Wang, Yi Ruan, Xin-Hua Zhou, Department of Hepatobiliary and Pancreatic Surgery, Li Huili Hospital Affiliated to Ningbo University, Ningbo 315000, Zhejiang Province, China
Co-corresponding authors: Xin-Hua Zhou and Yi Ruan.
Author contributions: Liu S, Liu YH, Ruan Y and Zhou XH designed the research study; Liu YH, Ni HB, Li JJ and Wu ZT performed the research; Liu S and Li JJ analyzed the data and wrote the manuscript; Liu S and Wang LL analyzed the data; Ruan Y and Zhou XH acquired funding and provided supervision; all authors have read and approved the final manuscript.
Supported by Zhejiang Province Medicine and Health Science and Technology Project, No. 2023KY239; and Zhejiang Province Traditional Chinese Medicine Science and Technology Plan Project, No. 2024ZL949.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Li Huili Hospital Affiliated to Ningbo University (No. KY2024SL463-01).
Informed consent statement: All study participants, or their legal guardians, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no known competing financial interest or personal relationships that could have appeared to influence the work reported in this paper.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: Technical appendix, statistical code, and dataset are available from the corresponding author at zhouxinhua1002@163.com. Participants gave informed consent for data sharing consent was not obtained but the presented data are anonymized and the risk of identification is low.
Corresponding author: Xin-Hua Zhou, Chief Physician, Professor, Department of Hepatobiliary and Pancreatic Surgery, Li Huili Hospital Affiliated to Ningbo University, No. 1111 Jiangnan Road, Yinzhou District, Ningbo 315000, Zhejiang Province, China. zhouxinhua1002@163.com
Received: March 9, 2025 Revised: April 7, 2025 Accepted: April 29, 2025 Published online: June 24, 2025 Processing time: 104 Days and 18.4 Hours
Abstract
BACKGROUND
Hepatocellular carcinoma with portal vein tumor thrombus (HCC-PVTT) is a severe condition with poor prognosis. While transarterial chemoembolization (TACE) combined with lenvatinib (TACE-L) shows some promise, survival outcomes remain suboptimal. We hypothesize that TACE-L plus programmed cell death protein-1 inhibitors (TACE-L-P) may offer superior survival benefits compared to TACE-L in this patient population.
AIM
To compare efficacy and safety of TACE-L-P vs TACE-L in HCC-PVTT and identify prognostic factors.
METHODS
Data from HCC-PVTT patients treated with TACE-L-P or TTACE-L from January 2018 to December 2023 were collected and retrospectively analyzed. Propensity score matching (PSM) method with optimal matching was used to minimize confounding bias. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and treatment-related adverse events (AEs) were compared between the two groups. Independent prognostic factors for OS and PFS were elucidated using the Cox proportional hazards model.
RESULTS
A total of 100 patients were included, with 42 patients in the TACE-L-P group and 68 patients in the TACE-L group. After PSM performing optimal matching, baseline characteristics were well balanced between the two groups, each comprising 42 patients. The median OS was significantly longer in the TACE-L-P group compared to the TACE-L group (17.2 months vs 12.6 months, P = 0.0207), as was the median PFS (10.6 months vs 7.1 months, P = 0.012). The ORR and disease control rate were both superior in the TACE-L-P group compared to the TACE-L group (66.7% vs 42.9%, P = 0.049; 78.6% vs 50.0%, P = 0.012). Multivariate analysis revealed that the independent prognostic factors for both OS and PFS were the treatment regimen and extrahepatic metastasis. The incidence of any-grade and grade 3 AEs was comparable between the TACE-L-P and TACE-L groups (84.5% vs 88.1%, P = 0.546), with no occurrences of grade 4/5 AEs or treatment-related mortality in either group.
CONCLUSION
Compared to TACE-L, the TACE-L-P regimen exhibits an acceptable safety profile and shows potential in improving survival outcomes, making it a promising therapeutic option for patients with HCC-PVTT.
Core Tip: This study evaluates the efficacy and safety of transarterial chemoembolization (TACE) combined with lenvatinib plus death protein-1 inhibitors (TACE-L-P) vs TACE combined with lenvatinib (TACE-L) in treating hepatocellular carcinoma with portal vein tumor thrombus (HCC-PVTT). The TACE-L-P regimen showed significantly improved overall survival, progression-free survival, and response rates compared to TACE-L. The safety profiles were comparable, with no severe treatment-related adverse events. These findings suggest that TACE-L-P may be a promising therapeutic option for HCC-PVTT patients.
