Lenvatinib, sintilimab combined interventional treatment vs bevacizumab, sintilimab combined interventional treatment for intermediate-advanced unresectable hepatocellular carcinoma

doi:10.3748/wjg.v30.i43.4620

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 30, Issue 43

This Article

Academic Content and Language Evaluation of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (121)

All Articles published online

The chart showing PDF series, HTML series, Figures (1-6) series, Tables (1-4) series.

Item

Count

PDF

HTML

Figures (1-6)

Tables (1-4)

Sum=55

Featured Article

The chart showing Browse series, Download series.

Item

Count

Browse

Download

Sum=57

Publishing Process of This Article

Item

Count

Browse

Download

Sum=1

Nov 21, 2024 (publication date) through Nov 1, 2024

Times Cited of This Article

Times Cited (0)

Journal Information of This Article

Publication Name

World Journal of Gastroenterology

ISSN

1007-9327

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Gastroenterol. Nov 21, 2024; 30(43): 4620-4635
Published online Nov 21, 2024. doi: 10.3748/wjg.v30.i43.4620

Table 1 Baseline characteristics of the bevacizumab plus sintilimab plus interventional treatment and lenvatinib plus sintilimab plus interventional treatment groups before and after propensity score matching, n (%)

Variable	Before PSM			After PSM
Variable	BeSiIT (n = 32)	LeSiIT (n = 95)	P value	BeSiIT (n = 28)	LeSiIT (n = 50)	P value
Age			1.000			0.835
< 65 years	24 (75.0)	70 (73.7)		21 (75.0)	35 (70.0)
≥ 65 years	8 (25.0)	25 (26.3)		7 (25.0)	15 (30.0)
Sex			0.663			0.916
Female	4 (12.5)	17 (17.9)		4 (14.3)	9 (18.0)
Male	28 (87.5)	78 (82.1)		24 (85.7)	41 (82.0)
Hepatitis			0.212			1.000
No	4 (12.5)	4 (4.2)		3 (10.7)	4 (8.0)
Yes	28 (87.5)	91 (95.8)		25 (89.3)	46 (92.0)
Liver cirrhosis			1.000			1.000
No	9 (28.1)	27 (28.4)		8 (28.6)	14 (28.0)
Yes	23 (71.9)	68 (71.6)		20 (71.4)	36 (72.0)
AFP, ng/mL			1.000			1.000
≤ 400	18 (56.2)	52 (54.7)		15 (53.6)	28 (56.0)
> 400	14 (43.8)	43 (45.3)		13 (46.4)	22 (44.0)
Tumor size, cm			0.532			0.689
≤ 10	20 (62.5)	67 (70.5)		17 (60.7)	34 (68.0)
> 10	12 (37.5)	28 (29.5)		11 (39.3)	16 (32.0)
Tumor number			0.021^a			0.953
≤ 3	24 (75.0)	47 (49.5)		20 (71.4)	34 (68.0)
> 3	8 (25.0)	48 (50.5)		8 (28.6)	16 (32.0)
Child-Pugh			0.880			1.000
A	26 (81.2)	74 (77.9)		23 (82.1)	40 (80.0)
B	6 (18.8)	21 (22.1)		5 (17.9)	10 (20.0)
BCLC stage			0.130			0.984
B	8 (25.0)	40 (42.1)		7 (25.0)	14 (28.0)
C	24 (75.0)	55 (57.9)		21 (75.0)	36 (72.0)
ECOG PS			0.136			0.673
0	26 (81.2)	59 (62.1)		22 (78.6)	36 (72.0)
1	5 (15.6)	31 (32.6)		5 (17.9)	13 (26.0)
2	1 (3.1)	5 (5.3)		1 (3.6)	1 (2.0)
Metastasis			0.327			1.000
No	20 (62.5)	70 (73.7)		19 (67.9)	34 (68.0)
Yes	12 (37.5)	25 (26.3)		9 (32.1)	16 (32.0)
Vascular invasion			0.027^a			0.417
No	12 (37.5)	59 (62.1)		10 (35.7)	24 (48.0)
Yes	20 (62.5)	36 (37.9)		18 (64.3)	26 (52.0)

^aP value < 0.05, and it is statistically significant.

PSM: Propensity score matching; BeSiIT: Bevacizumab plus sintilimab plus interventional treatment; LeSiIT: Lenvatinib plus sintilimab plus interventional treatment; AFP: Α-fetoprotein; BCLC: The Barcelona Clinic Liver Cancer; ECOG PS: Eastern Cooperative Oncology Group Performance Status.

Table 2 Summary of the best responses, n (%)

Variable	RECIST 11			mRECIST
Variable	BeSiIT (n = 28)	LeSiIT (n = 50)	P value	BeSiIT (n = 28)	LeSiIT (n = 50)	P value
CR	0 (0.0)	0 (0.0)	-	8 (28.6)	4 (8.0)	0.016^a
PR	17 (60.7)	23 (46.0)	0.212	9 (32.1)	25 (50.0)	0.127
SD	5 (17.9)	7 (14.0)	0.651	5 (17.9)	5 (1.0)	0.319
PD	6 (21.4)	20 (40.0)	0.095	6 (21.4)	16 (32.0)	0.320
ORR	17 (60.7)	23 (46.0)	0.791	17 (60.7)	29 (58.0)	0.815
DCR	22 (78.6)	30 (60.0)	0.095	22 (78.6)	34 (68.0)	0.320

^aP value < 0.05, and it is statistically significant.

RECIST: Response Evaluation Criteria in Solid Tumors; mRECIST: Modified Response Evaluation Criteria in Solid Tumors; BeSiIT: Bevacizumab plus sintilimab plus interventional treatment; LeSiIT: Lenvatinib plus sintilimab plus interventional treatment; CR: Complete response; PR: Partial response; SD: Stable disease; PD: Progressive disease; ORR: Objective response rate; DCR: Disease control rate.

Table 3 A summary of adverse reactions in the bevacizumab plus sintilimab plus interventional treatment and lenvatinib plus sintilimab plus interventional treatment groups, n (%)

Variable	BeSiIT (n = 28)		LeSiIT (n = 50)		P value
Variable	Any grade	Grade 3 or 4	Any grade	Grade 3 or 4	Any grade	Grade 3 or 4
Thrombocytopenia	8 (28.5)	2 (7.1)	9 (18.0)	0 (0.0)	0.335	0.059
Neutropenia	4 (14.3)	0 (0.0)	9 (18.0)	1 (2.0)	0.699	0.454
Hypertension	5 (17.9)	0 (0.0)	15 (30.0)	7 (14.0)	0.306	0.047^a
Rash	4 (14.3)	0 (0.0)	8 (16.0)	1 (2.0)	0.853	0.454
Hand-foot skin reaction	4 (14.3)	0 (0.0)	8 (16.0)	1 (2.0)	0.853	0.454
Abdominal pain	1 (3.6)	0 (0.0)	3 (6.0)	1 (2.0)	0.649	0.454
Bleeding	1 (3.6)	0 (0.0)	7 (14.0)	0 (0.0)	0.167	-
Fever	2 (7.1)	0 (0.0)	0 (0.0)	0 (0.0)	0.059	-
Nausea	0 (0.0)	0 (0.0)	10 (20.0)	0 (0.0)	0.018^a	-
Decreased appetite	1 (3.6)	0 (0.0)	12 (24.0)	0 (0.0)	0.033^a	-
Diarrhea	0 (0.0)	0 (0.0)	10 (20.0)	0 (0.0)	0.018^a	-
Fatigue	2 (7.1)	0 (0.0)	16 (32.0)	2 (4.0)	0.027^a	0.290
Vomiting	0 (0.0)	0 (0.0)	8 (16.0)	0 (0.0)	0.034^a	-
Proteinuria	8 (28.5)	0 (0.0)	5 (10.0)	0 (0.0)	0.053	-
Hyperbilirubinemia	6 (21.4)	0 (0.0)	11 (22.0)	0 (0.0)	0.958	-
Elevated ALT	2 (7.1)	0 (0.0)	8 (16.0)	0 (0.0)	0.293	-
Elevated AST	6 (21.4)	0 (0.0)	13 (26.0)	1 (2.0)	0.693	0.677
Hypoalbuminemia	2 (7.1)	0 (0.0)	7 (14.0)	0 (0.0)	0.391	-

^aP value < 0.05, and it is statistically significant.

BeSiIT: Bevacizumab plus sintilimab plus interventional treatment; LeSiIT: Lenvatinib plus sintilimab plus interventional treatment; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase.

Table 4 Univariate and multivariate Cox regression analysis of clinical characteristics with progression-free survival as the dependent variable

Independent variables	Univariate		Multivariate
Independent variables	HR (95%CI)	P value	HR (95%CI)	P value
Group (LeSiIT/BeSiIT)	0.876 (0.460-1.670)	0.688
Tumor size (> 10/≤ 10 cm)	1.143 (0.597-2.187)	0.687
Tumor number (> 3/≤ 3)	0.759 (0.369-1.561)	0.453
Gender (male/female)	0.969 (0.404-2.321)	0.943
Age (years)	0.989 (0.961-1.017)	0.432
Age (≥ 65/< 65 years)	0.878 (0.425-1.813)	0.725
Etiology (yes/no)	0.559 (0.196-1.598)	0.278
Liver cirrhosis (yes/no)	0.735 (0.375-1.440)	0.369
Metastasis (yes/no)	0.767 (0.391-1.504)	0.440
Vascular invasion (yes/no)	1.041 (0.554-1.957)	0.900
Child-Pugh (B/A)	1.390 (0.655-2.951)	0.391
BCLC stage (C/B)	0.869 (0.432-1.750)	0.694
ECOG PS
0	Reference	-
1	1.562 (0.772-3.163)	0.215
2	NA	0.972
ALBI grade
1	Reference	-
2	0.668 (0.343-1.301)	0.235
3	1.643 (0.382-7.069)	0.505
AFP concentration (ng/mL)	1.000 (1.000-1.000)	0.042^a	1.000 (1.000-1.000)	0.191
AFP (> 28.0/≤ 28.0 ng/mL)	1.754 (0.830-3.708)	0.141
CEA (> 3.6/≤ 3.6 ng/mL)	1.645 (0.811-3.338)	0.168
AFCE
0	Reference	-	Reference	-
1	3.255 (1.244-8.516)	0.016^a	2.973 (1.120-7.888)	0.029^a
2	6.153 (2.011-18.821)	0.001^a	5.746 (1.865-17.708)	0.002^a

^aP value less than < 0.05, and it is statistically significant.

PFS: Progression-free survival; HR: Hazard ratios; BeSiIT: Bevacizumab plus sintilimab plus interventional treatment; LeSiIT: Lenvatinib plus sintilimab plus interventional treatment; BCLC: The Barcelona Clinic Liver Cancer; ECOG PS: Eastern Cooperative Oncology Group Performance Status; NA: Not available; ALBI: Albumin-bilirubin; AFP: Α-fetoprotein; CEA: Carcinoembryonic antigen; AFCE: Α-fetoprotein and carcinoembryonic antigen score.

Citation: Han RY, Gan LJ, Lang MR, Ren SH, Liu DM, Li GT, Liu YY, Tian XD, Zhu KW, Sun LY, Chen L, Song TQ. Lenvatinib, sintilimab combined interventional treatment vs bevacizumab, sintilimab combined interventional treatment for intermediate-advanced unresectable hepatocellular carcinoma. World J Gastroenterol 2024; 30(43): 4620-4635
URL: https://www.wjgnet.com/1007-9327/full/v30/i43/4620.htm
DOI: https://dx.doi.org/10.3748/wjg.v30.i43.4620