Published online Feb 28, 2024. doi: 10.3748/wjg.v30.i8.843
Peer-review started: September 27, 2023
First decision: December 4, 2023
Revised: December 18, 2023
Accepted: January 25, 2024
Article in press: January 25, 2024
Published online: February 28, 2024
Hepatocellular carcinoma (HCC) patients complicated with portal vein tumor thrombus (PVTT) exhibit poor prognoses and treatment responses.
To investigate efficacies and safety of the combination of PD-1 inhibitor, transcatheter arterial chemoembolization (TACE) and Lenvatinib in HCC subjects comorbid with PVTT.
From January 2019 to December 2020, HCC patients with PVTT types I-IV were retrospectively enrolled at Beijing Ditan Hospital. They were distributed to either the PTL or TACE/Lenvatinib (TL) group. The median progression-free survival (mPFS) was set as the primary endpoint, while parameters like median overall survival, objective response rate, disease control rate (DCR), and toxicity level served as secondary endpoints.
Forty-one eligible patients were finally recruited for this study and divided into the PTL (n = 18) and TL (n = 23) groups. For a median follow-up of 21.8 months, the DCRs were 88.9% and 60.9% in the PTL and TL groups (P = 0.046), res-pectively. Moreover, mPFS indicated significant improvement (HR = 0.25; P < 0.001) in PTL-treated patients (5.4 months) compared to TL-treated (2.7 months) patients. There were no treatment-related deaths or differences in adverse events in either group.
A triplet regimen of PTL was safe and well-tolerated as well as exhibited favorable efficacy over the TL regimen for advanced-stage HCC patients with PVTT types I-IV.
Core Tip: Hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) has a poor prognosis and treatment responses. Assessment of its survival has important clinical implications. Through our research, we discovered that a triplet regimen of PD-1 inhibitor/transcatheter arterial chemoembolization/Lenvatinib was safe and well-tolerated as well as exhibited favorable efficacy over the transcatheter arterial chemoembolization/Lenvatinib regimen for advanced-stage HCC comorbid with PVTT.