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
ARTICLE HIGHLIGHTS
Research background

The incidence and mortality of hepatocellular carcinoma (HCC) are among the highest in the world. There are a large number of advanced liver cancer patients with portal vein cancer embolus, and the prognosis is worse. Therefore, it is necessary to explore the treatment plan that can prolong the survival of liver cancer patients with portal vein cancer embolus.

Research motivation

To compare the efficacies and safety levels of the PD-1 inhibitor/TACE/Lenvatinib (PTL) regimen and TACE/Lenvatinib (TL) regimen for HCC subjects comorbid with portal vein tumor thrombus (PVTT), providing a choice for exploring the combination drug regimen that can prolong the survival of HCC with PVTT.

Research objectives

Our research aims to compare the efficacies and safety levels of the PTL regimen and TL regimen for HCC subjects comorbid with PVTT. We found 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. The triple therapy regimen may better improve the prognosis of advanced liver cancer patients with portal vein cancer suppository and extend their survival time, which is of great significance.

Research methods

We selected HCC patients with PVTT type Ⅰ-Ⅳ, TACE was carried out by 2 professional radiologists.

Research results

The triple therapy regimen may better improve the prognosis of advanced liver cancer patients with portal vein cancer suppository and extend their survival time. Large-scale prospective studies are needed to further validate the efficacy and safety of the triple therapy regimen in the future.

Research conclusions

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. The combination therapy of TACE, TKI and PD-1 inhibitor was used for advanced liver cancer patients with portal vein cancer embolus.

Research perspectives

Large-scale prospective studies are needed to further validate the efficacy and safety of the triple therapy regimen in the future.