Transarterial chemoembolization for advanced hepatocellular carcinoma after failure of first-line systemic treatment: a single-center case series

Abstract Background & aims To demonstrate the potential benefits of additional transarterial chemoembolization (TACE) for advanced hepatocellular carcinoma (HCC) after the failure of first-line systemic treatment (ST). Methods This retrospective single-center study was conducted between January...

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Main Authors: Qingyu Xu, Bin Leng, Ran You, Lingfeng Diao, Chendong Wang, Zeyu Yu, Guowen Yin
Format: Article
Language:English
Published: Springer 2025-08-01
Series:Discover Oncology
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Online Access:https://doi.org/10.1007/s12672-025-03363-9
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author Qingyu Xu
Bin Leng
Ran You
Lingfeng Diao
Chendong Wang
Zeyu Yu
Guowen Yin
author_facet Qingyu Xu
Bin Leng
Ran You
Lingfeng Diao
Chendong Wang
Zeyu Yu
Guowen Yin
author_sort Qingyu Xu
collection DOAJ
description Abstract Background & aims To demonstrate the potential benefits of additional transarterial chemoembolization (TACE) for advanced hepatocellular carcinoma (HCC) after the failure of first-line systemic treatment (ST). Methods This retrospective single-center study was conducted between January 2020 and December 2022 on patients with advanced HCC who failed to respond to initial first-line ST. Patients who had previously undergone TACE were excluded. Eligible patients underwent on-demand TACE in addition to ST and were followed until death or until March 2023. The duration of response was recorded. Overall survival (OS) was calculated from the date of failure of first-line ST to the date of death or last follow-up. The primary outcomes were OS and safety, and the secondary outcomes were time to progression (TTP) and objective response rate (ORR). Results In total, 18 patients were included; 8 patients had failed to respond to lenvatinib or sorafenib monotherapy, and 10 had failed to respond to a combination therapy. The most common progression pattern was the development of new intrahepatic lesions. Salvage treatment consisted of 16 triple therapies and 2 dual therapies, including TACE. The median duration of follow-up was 9.5 months. The median OS from the start of second-line treatment was 24 months. The median TTP was 3.5 months. The ORR was 55.6%, and disease control was achieved in 94.4% of patients. Treatment-related adverse events were common but acceptable. Conclusions Patients with advanced HCC who face significant treatment challenges could potentially benefit from the addition of TACE to second-line ST.
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spelling doaj-art-d585ac4df28c4733bea128f86121dc4d2025-08-20T03:46:12ZengSpringerDiscover Oncology2730-60112025-08-0116111410.1007/s12672-025-03363-9Transarterial chemoembolization for advanced hepatocellular carcinoma after failure of first-line systemic treatment: a single-center case seriesQingyu Xu0Bin Leng1Ran You2Lingfeng Diao3Chendong Wang4Zeyu Yu5Guowen Yin6Department of Interventional Radiology, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical UniversityDepartment of Interventional Radiology, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical UniversityDepartment of Interventional Radiology, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical UniversityDepartment of Interventional Radiology, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical UniversityDepartment of Interventional Radiology, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical UniversityDepartment of Interventional Radiology, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical UniversityDepartment of Interventional Radiology, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical UniversityAbstract Background & aims To demonstrate the potential benefits of additional transarterial chemoembolization (TACE) for advanced hepatocellular carcinoma (HCC) after the failure of first-line systemic treatment (ST). Methods This retrospective single-center study was conducted between January 2020 and December 2022 on patients with advanced HCC who failed to respond to initial first-line ST. Patients who had previously undergone TACE were excluded. Eligible patients underwent on-demand TACE in addition to ST and were followed until death or until March 2023. The duration of response was recorded. Overall survival (OS) was calculated from the date of failure of first-line ST to the date of death or last follow-up. The primary outcomes were OS and safety, and the secondary outcomes were time to progression (TTP) and objective response rate (ORR). Results In total, 18 patients were included; 8 patients had failed to respond to lenvatinib or sorafenib monotherapy, and 10 had failed to respond to a combination therapy. The most common progression pattern was the development of new intrahepatic lesions. Salvage treatment consisted of 16 triple therapies and 2 dual therapies, including TACE. The median duration of follow-up was 9.5 months. The median OS from the start of second-line treatment was 24 months. The median TTP was 3.5 months. The ORR was 55.6%, and disease control was achieved in 94.4% of patients. Treatment-related adverse events were common but acceptable. Conclusions Patients with advanced HCC who face significant treatment challenges could potentially benefit from the addition of TACE to second-line ST.https://doi.org/10.1007/s12672-025-03363-9Transarterial chemoembolization plus systemic treatmentAdvanced hepatocellular carcinomaSecond-line option
spellingShingle Qingyu Xu
Bin Leng
Ran You
Lingfeng Diao
Chendong Wang
Zeyu Yu
Guowen Yin
Transarterial chemoembolization for advanced hepatocellular carcinoma after failure of first-line systemic treatment: a single-center case series
Discover Oncology
Transarterial chemoembolization plus systemic treatment
Advanced hepatocellular carcinoma
Second-line option
title Transarterial chemoembolization for advanced hepatocellular carcinoma after failure of first-line systemic treatment: a single-center case series
title_full Transarterial chemoembolization for advanced hepatocellular carcinoma after failure of first-line systemic treatment: a single-center case series
title_fullStr Transarterial chemoembolization for advanced hepatocellular carcinoma after failure of first-line systemic treatment: a single-center case series
title_full_unstemmed Transarterial chemoembolization for advanced hepatocellular carcinoma after failure of first-line systemic treatment: a single-center case series
title_short Transarterial chemoembolization for advanced hepatocellular carcinoma after failure of first-line systemic treatment: a single-center case series
title_sort transarterial chemoembolization for advanced hepatocellular carcinoma after failure of first line systemic treatment a single center case series
topic Transarterial chemoembolization plus systemic treatment
Advanced hepatocellular carcinoma
Second-line option
url https://doi.org/10.1007/s12672-025-03363-9
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