Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 28, 2024; 30(8): 843-854
Published online Feb 28, 2024. doi: 10.3748/wjg.v30.i8.843
Transcatheter arterial chemoembolization combined with PD-1 inhibitors and Lenvatinib for hepatocellular carcinoma with portal vein tumor thrombus
Hong-Xiao Wu, Xiao-Yan Ding, Ya-Wen Xu, Ming-Hua Yu, Xiao-Mi Li, Na Deng, Jing-Long Chen
Hong-Xiao Wu, Xiao-Yan Ding, Ya-Wen Xu, Ming-Hua Yu, Xiao-Mi Li, Na Deng, Jing-Long Chen, Cancer Center, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
Co-first authors: Hong-Xiao Wu and Xiao-Yan Ding.
Author contributions: Chen JL and Ding XX designed the research; Wu HX, Xu YW, Yu MH, Li XM and Deng N contributed data collection; Chen JL, Ding XX, Wu HX, Xu YW, Yu MH, Li XM and Deng N contributed manuscript review; Wu HX and Ding XY performed the research, wrote the paper, and completed data collection, data analysis and manuscript revision, so we consider these two authors to have equal contributions and can be regarded as a co-first author; all authors have read and agreed to the published version of the manuscript.
Institutional review board statement: The study was reviewed and approved by the Beijing Ditan Hospital,Capital Medical University Institutional Review Board (Approval No. JDLC 2021-003 -02).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors certify that there is no conflict of interest related to the manuscript.
Data sharing statement: The dataset used for this study is available from the corresponding author upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jing-Long Chen, Doctor, Chief Doctor, Cancer Center, Beijing Ditan Hospital, Capital Medical University, No. 8 Jingshun East Street, Chaoyang District, Beijing 100015, China. cjl6412@ccmu.edu.cn
Received: September 27, 2023
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
Processing time: 152 Days and 5.6 Hours
Abstract
BACKGROUND

Hepatocellular carcinoma (HCC) patients complicated with portal vein tumor thrombus (PVTT) exhibit poor prognoses and treatment responses.

AIM

To investigate efficacies and safety of the combination of PD-1 inhibitor, transcatheter arterial chemoembolization (TACE) and Lenvatinib in HCC subjects comorbid with PVTT.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

Keywords: Hepatocellular carcinoma; Transcatheter arterial chemoembolization; Lenvatinib; PD-1 inhibitor; Portal vein tumor thrombus

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.