Efficacy and Safety of Lenvatinib Plus Programmed Death-1 Inhibitors with or Without Transarterial Chemoembolization in the Treatment of Unresectable Hepatocellular Carcinoma
Ming Jin,1,* Zhi-qing Jiang,2,* Jia-hui Qin,3,* Hui-xia Qin,4,* Kai-wen Jiang,3,* Hou-xiang Ya,3 Jing Gu,3 Mo-rui Gui,5 Yao-hua Li,3 Long-kuan Xu,6 Hai-xiao Fu,6 Xu-hua Xiao,7 Shu-qun Li3 1Department of Vascular Intervention, Affiliated Hospital of Guilin Medi...
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Dove Medical Press
2024-11-01
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| Series: | Journal of Hepatocellular Carcinoma |
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| Online Access: | https://www.dovepress.com/efficacy-and-safety-of-lenvatinib-plus-programmed-death-1-inhibitors-w-peer-reviewed-fulltext-article-JHC |
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| author | Jin M Jiang ZQ Qin JH Qin HX Jiang KW Ya HX Gu J Gui MR Li YH Xu LK Fu HX Xiao XH Li SQ |
| author_facet | Jin M Jiang ZQ Qin JH Qin HX Jiang KW Ya HX Gu J Gui MR Li YH Xu LK Fu HX Xiao XH Li SQ |
| author_sort | Jin M |
| collection | DOAJ |
| description | Ming Jin,1,* Zhi-qing Jiang,2,* Jia-hui Qin,3,* Hui-xia Qin,4,* Kai-wen Jiang,3,* Hou-xiang Ya,3 Jing Gu,3 Mo-rui Gui,5 Yao-hua Li,3 Long-kuan Xu,6 Hai-xiao Fu,6 Xu-hua Xiao,7 Shu-qun Li3 1Department of Vascular Intervention, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, People’s Republic of China; 2Department of Gastrointestinal Surgery, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, People’s Republic of China; 3Department of Hepatobiliary Pancreatic Surgery, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, People’s Republic of China; 4Interventional Center, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, People’s Republic of China; 5Department of Burn Wound Repair and Plastic Surgery, Medical Aesthetic Surgery, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, People’s Republic of China; 6Department of Pathology, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, People’s Republic of China; 7Department of Gastroenterology, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shu-qun Li, Email lishuqun2008@126.comPurpose: Transarterial chemoembolization (TACE) is recommended as a standard therapy for intermediate-stage hepatocellular carcinoma (HCC) and is the most widely used first-line treatment for advanced HCC. This study aimed to evaluate the clinical benefits and tolerability of TACE added to a combination of lenvatinib and programmed death-1 (PD-1) inhibitor in patients with unresectable HCC (uHCC).Patients and Methods: We conducted a retrospective cohort study involving 144 patients with uHCC treated between August 2020 and August 2023. Patients received a combination of lenvatinib and a PD-1 inhibitor with or without TACE (T+L+P, n=81 or L+P, n=63, respectively). The baseline characteristics of the two groups were compared, and propensity score matching (PSM) was used to minimize bias. The study endpoints included overall survival (OS), progression-free survival (PFS), and objective response rate (ORR). Factors influencing survival rates were analyzed using Cox regression, and adverse events (AEs) were documented and assessed.Results: Before PSM, the T+L+P group showed significantly higher ORR (64.1% vs 44.4%, p < 0.05), longer median PFS (14.3 vs 9.6 months, p < 0.05), and longer median OS (24.6 vs 19.5 months, p < 0.05) compared to the L+P group. Even post-PSM, the T+L+P group showed significantly better OS and PFS compared to the L+P group (mOS: 28.0 vs 17.6 months p=0.0011, mPFS: 15.8 vs 9.3 months, p < 0.05). Univariate and multivariate analyses identified treatment options as independent factors for PFS and OS. The safety profile of the T+L+P regimen was acceptableThe incidence and severity of adverse reactions in the T+L+P group were not significantly different compared to the L+P group (any grade, 90.1 vs 93.6%, p=0.551; grade≥ 3, 25.9 vs 23.8%, p=0.843).Keywords: unresectable hepatocellular carcinoma, lenvatinib, transarterial chemoembolization, PD-1 inhibitor, combination therapy, propensity score matching |
| format | Article |
| id | doaj-art-de755f3d18494613bb0939e02f5709e0 |
| institution | OA Journals |
| issn | 2253-5969 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Hepatocellular Carcinoma |
| spelling | doaj-art-de755f3d18494613bb0939e02f5709e02025-08-20T01:53:44ZengDove Medical PressJournal of Hepatocellular Carcinoma2253-59692024-11-01Volume 112309232097655Efficacy and Safety of Lenvatinib Plus Programmed Death-1 Inhibitors with or Without Transarterial Chemoembolization in the Treatment of Unresectable Hepatocellular CarcinomaJin MJiang ZQQin JHQin HXJiang KWYa HXGu JGui MRLi YHXu LKFu HXXiao XHLi SQMing Jin,1,* Zhi-qing Jiang,2,* Jia-hui Qin,3,* Hui-xia Qin,4,* Kai-wen Jiang,3,* Hou-xiang Ya,3 Jing Gu,3 Mo-rui Gui,5 Yao-hua Li,3 Long-kuan Xu,6 Hai-xiao Fu,6 Xu-hua Xiao,7 Shu-qun Li3 1Department of Vascular Intervention, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, People’s Republic of China; 2Department of Gastrointestinal Surgery, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, People’s Republic of China; 3Department of Hepatobiliary Pancreatic Surgery, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, People’s Republic of China; 4Interventional Center, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, People’s Republic of China; 5Department of Burn Wound Repair and Plastic Surgery, Medical Aesthetic Surgery, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, People’s Republic of China; 6Department of Pathology, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, People’s Republic of China; 7Department of Gastroenterology, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shu-qun Li, Email lishuqun2008@126.comPurpose: Transarterial chemoembolization (TACE) is recommended as a standard therapy for intermediate-stage hepatocellular carcinoma (HCC) and is the most widely used first-line treatment for advanced HCC. This study aimed to evaluate the clinical benefits and tolerability of TACE added to a combination of lenvatinib and programmed death-1 (PD-1) inhibitor in patients with unresectable HCC (uHCC).Patients and Methods: We conducted a retrospective cohort study involving 144 patients with uHCC treated between August 2020 and August 2023. Patients received a combination of lenvatinib and a PD-1 inhibitor with or without TACE (T+L+P, n=81 or L+P, n=63, respectively). The baseline characteristics of the two groups were compared, and propensity score matching (PSM) was used to minimize bias. The study endpoints included overall survival (OS), progression-free survival (PFS), and objective response rate (ORR). Factors influencing survival rates were analyzed using Cox regression, and adverse events (AEs) were documented and assessed.Results: Before PSM, the T+L+P group showed significantly higher ORR (64.1% vs 44.4%, p < 0.05), longer median PFS (14.3 vs 9.6 months, p < 0.05), and longer median OS (24.6 vs 19.5 months, p < 0.05) compared to the L+P group. Even post-PSM, the T+L+P group showed significantly better OS and PFS compared to the L+P group (mOS: 28.0 vs 17.6 months p=0.0011, mPFS: 15.8 vs 9.3 months, p < 0.05). Univariate and multivariate analyses identified treatment options as independent factors for PFS and OS. The safety profile of the T+L+P regimen was acceptableThe incidence and severity of adverse reactions in the T+L+P group were not significantly different compared to the L+P group (any grade, 90.1 vs 93.6%, p=0.551; grade≥ 3, 25.9 vs 23.8%, p=0.843).Keywords: unresectable hepatocellular carcinoma, lenvatinib, transarterial chemoembolization, PD-1 inhibitor, combination therapy, propensity score matchinghttps://www.dovepress.com/efficacy-and-safety-of-lenvatinib-plus-programmed-death-1-inhibitors-w-peer-reviewed-fulltext-article-JHCunresectable hepatocellular carcinomalenvatinibtransarterial chemoembolizationpd-1 inhibitorcombination therapypropensity score matching. |
| spellingShingle | Jin M Jiang ZQ Qin JH Qin HX Jiang KW Ya HX Gu J Gui MR Li YH Xu LK Fu HX Xiao XH Li SQ Efficacy and Safety of Lenvatinib Plus Programmed Death-1 Inhibitors with or Without Transarterial Chemoembolization in the Treatment of Unresectable Hepatocellular Carcinoma Journal of Hepatocellular Carcinoma unresectable hepatocellular carcinoma lenvatinib transarterial chemoembolization pd-1 inhibitor combination therapy propensity score matching. |
| title | Efficacy and Safety of Lenvatinib Plus Programmed Death-1 Inhibitors with or Without Transarterial Chemoembolization in the Treatment of Unresectable Hepatocellular Carcinoma |
| title_full | Efficacy and Safety of Lenvatinib Plus Programmed Death-1 Inhibitors with or Without Transarterial Chemoembolization in the Treatment of Unresectable Hepatocellular Carcinoma |
| title_fullStr | Efficacy and Safety of Lenvatinib Plus Programmed Death-1 Inhibitors with or Without Transarterial Chemoembolization in the Treatment of Unresectable Hepatocellular Carcinoma |
| title_full_unstemmed | Efficacy and Safety of Lenvatinib Plus Programmed Death-1 Inhibitors with or Without Transarterial Chemoembolization in the Treatment of Unresectable Hepatocellular Carcinoma |
| title_short | Efficacy and Safety of Lenvatinib Plus Programmed Death-1 Inhibitors with or Without Transarterial Chemoembolization in the Treatment of Unresectable Hepatocellular Carcinoma |
| title_sort | efficacy and safety of lenvatinib plus programmed death 1 inhibitors with or without transarterial chemoembolization in the treatment of unresectable hepatocellular carcinoma |
| topic | unresectable hepatocellular carcinoma lenvatinib transarterial chemoembolization pd-1 inhibitor combination therapy propensity score matching. |
| url | https://www.dovepress.com/efficacy-and-safety-of-lenvatinib-plus-programmed-death-1-inhibitors-w-peer-reviewed-fulltext-article-JHC |
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