Prognostic impact of tace combined with sorafenib or lenvatinib followed by regorafenib in recurrent hepatocellular carcinoma after liver transplantation: a retrospective study

Abstract Background Tumor recurrence after liver transplantation (LT) for hepatocellular carcinoma (HCC) remains a significant challenge. This study systematically evaluates the efficacy and safety of transarterial chemoembolization (TACE) combined with tyrosine kinase inhibitors (TKIs) for post-LT...

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Main Authors: Zhao-dan Ye, Meng-chen Song, Al-Kalei AMA, Li Zhuang, Yan Zhang, Sheng-li Ye, He-miao Shi, Si-yi Zhong, Dan Zhu, Guo-hong Cao, Jing-feng Zhang
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-025-14446-9
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author Zhao-dan Ye
Meng-chen Song
Al-Kalei AMA
Li Zhuang
Yan Zhang
Sheng-li Ye
He-miao Shi
Si-yi Zhong
Dan Zhu
Guo-hong Cao
Jing-feng Zhang
author_facet Zhao-dan Ye
Meng-chen Song
Al-Kalei AMA
Li Zhuang
Yan Zhang
Sheng-li Ye
He-miao Shi
Si-yi Zhong
Dan Zhu
Guo-hong Cao
Jing-feng Zhang
author_sort Zhao-dan Ye
collection DOAJ
description Abstract Background Tumor recurrence after liver transplantation (LT) for hepatocellular carcinoma (HCC) remains a significant challenge. This study systematically evaluates the efficacy and safety of transarterial chemoembolization (TACE) combined with tyrosine kinase inhibitors (TKIs) for post-LT tumor recurrence. Methods This retrospective study included 78 patients with recurrent intrahepatic HCC after LT. Seventy patients received TACE in combination with either sorafenib or lenvatinib, followed by regorafenib. Outcomes evaluated included time to progression (TTP), post-recurrence survival (PRS), post-transplantation survival (PTS), objective response rate (ORR), and adverse events (AEs). Results The median TTP for recurrent intrahepatic HCC with combination therapy was 6 months (95% CI: 3.685–8.315), while the median PRS and PTS were 16 months (95% CI: 13.049–18.951) and 25 months (95% CI: 20.447–29.553), respectively. The ORR for intrahepatic tumors was 71.4%. AEs, including post-embolization syndrome and myelosuppression, were manageable. Conclusion TACE combined with TKIs has good efficacy and safety in the treatment of HCC recurrence post-LT and is expected to prolong survival.
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spelling doaj-art-66f8d45d40df43189509294afd7d89522025-08-20T03:03:41ZengBMCBMC Cancer1471-24072025-07-0125111010.1186/s12885-025-14446-9Prognostic impact of tace combined with sorafenib or lenvatinib followed by regorafenib in recurrent hepatocellular carcinoma after liver transplantation: a retrospective studyZhao-dan Ye0Meng-chen Song1Al-Kalei AMA2Li Zhuang3Yan Zhang4Sheng-li Ye5He-miao Shi6Si-yi Zhong7Dan Zhu8Guo-hong Cao9Jing-feng Zhang10Department of Radiology, Shulan (Hangzhou) Hospital, Shulan International Medical College, Zhejiang Shuren UniversityDepartment of Radiology, Shulan (Hangzhou) Hospital, Shulan International Medical College, Zhejiang Shuren UniversityDepartment of Radiology, Shulan (Hangzhou) Hospital, Shulan International Medical College, Zhejiang Shuren UniversityDepartment of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital, Shulan International Medical College, Zhejiang Shuren UniversityDepartment of Radiology, Shulan (Hangzhou) Hospital, Shulan International Medical College, Zhejiang Shuren UniversityDepartment of Radiology, Shulan (Hangzhou) Hospital, Shulan International Medical College, Zhejiang Shuren UniversityDepartment of Radiology, Zhejiang HospitalDepartment of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital, Shulan International Medical College, Zhejiang Shuren UniversityDepartment of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital, Shulan International Medical College, Zhejiang Shuren UniversityDepartment of Radiology, Shulan (Hangzhou) Hospital, Shulan International Medical College, Zhejiang Shuren UniversityDepartment of Radiology, Ningbo No.2 Hospital, Haishu DistrictAbstract Background Tumor recurrence after liver transplantation (LT) for hepatocellular carcinoma (HCC) remains a significant challenge. This study systematically evaluates the efficacy and safety of transarterial chemoembolization (TACE) combined with tyrosine kinase inhibitors (TKIs) for post-LT tumor recurrence. Methods This retrospective study included 78 patients with recurrent intrahepatic HCC after LT. Seventy patients received TACE in combination with either sorafenib or lenvatinib, followed by regorafenib. Outcomes evaluated included time to progression (TTP), post-recurrence survival (PRS), post-transplantation survival (PTS), objective response rate (ORR), and adverse events (AEs). Results The median TTP for recurrent intrahepatic HCC with combination therapy was 6 months (95% CI: 3.685–8.315), while the median PRS and PTS were 16 months (95% CI: 13.049–18.951) and 25 months (95% CI: 20.447–29.553), respectively. The ORR for intrahepatic tumors was 71.4%. AEs, including post-embolization syndrome and myelosuppression, were manageable. Conclusion TACE combined with TKIs has good efficacy and safety in the treatment of HCC recurrence post-LT and is expected to prolong survival.https://doi.org/10.1186/s12885-025-14446-9Hepatocellular carcinomaTransarterial chemoembolizationLiver transplantationRecurrenceTyrosine kinase inhibitors
spellingShingle Zhao-dan Ye
Meng-chen Song
Al-Kalei AMA
Li Zhuang
Yan Zhang
Sheng-li Ye
He-miao Shi
Si-yi Zhong
Dan Zhu
Guo-hong Cao
Jing-feng Zhang
Prognostic impact of tace combined with sorafenib or lenvatinib followed by regorafenib in recurrent hepatocellular carcinoma after liver transplantation: a retrospective study
BMC Cancer
Hepatocellular carcinoma
Transarterial chemoembolization
Liver transplantation
Recurrence
Tyrosine kinase inhibitors
title Prognostic impact of tace combined with sorafenib or lenvatinib followed by regorafenib in recurrent hepatocellular carcinoma after liver transplantation: a retrospective study
title_full Prognostic impact of tace combined with sorafenib or lenvatinib followed by regorafenib in recurrent hepatocellular carcinoma after liver transplantation: a retrospective study
title_fullStr Prognostic impact of tace combined with sorafenib or lenvatinib followed by regorafenib in recurrent hepatocellular carcinoma after liver transplantation: a retrospective study
title_full_unstemmed Prognostic impact of tace combined with sorafenib or lenvatinib followed by regorafenib in recurrent hepatocellular carcinoma after liver transplantation: a retrospective study
title_short Prognostic impact of tace combined with sorafenib or lenvatinib followed by regorafenib in recurrent hepatocellular carcinoma after liver transplantation: a retrospective study
title_sort prognostic impact of tace combined with sorafenib or lenvatinib followed by regorafenib in recurrent hepatocellular carcinoma after liver transplantation a retrospective study
topic Hepatocellular carcinoma
Transarterial chemoembolization
Liver transplantation
Recurrence
Tyrosine kinase inhibitors
url https://doi.org/10.1186/s12885-025-14446-9
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