Editorial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jul 15, 2024; 16(7): 2884-2887
Published online Jul 15, 2024. doi: 10.4251/wjgo.v16.i7.2884
Effectiveness of transarterial chemoembolization in combination with lenvatinib and programmed cell death protein-1 inhibition for unresectable hepatocellular carcinoma
Meer M Chisthi
Meer M Chisthi, Department of General Surgery, Government Medical College Pathanamthitta, Konni 689691, Kerala, India
Author contributions: Chisthi MM was responsible for all work on the manuscript.
Conflict-of-interest statement: Dr. Chisthi declares having no conflicts of interest to disclose.
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 Non-Commercial (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: Meer M Chisthi, MBBS, MS, Professor, Surgeon, Department of General Surgery, Government Medical College Pathanamthitta, Aanakuthi, Konni 689691, Kerala, India. meerchisthi@gmail.com
Received: February 27, 2024
Revised: April 18, 2024
Accepted: April 29, 2024
Published online: July 15, 2024
Processing time: 136 Days and 5.8 Hours
Abstract

This editorial comments on the study by Ma et al, which delves into the efficacy and predictive factors associated with the combination of transarterial chemoembolization, lenvatinib, and programmed cell death protein-1 inhibition for the management of unresectable hepatocellular carcinoma. Analysing data from a retrospective study involving 102 patients, the treatment showcased a median overall survival (OS) of 26.43 months and a median progression-free survival (PFS) of 10.07 months. Notably, the objective response rate and disease control rate reached 61.76% and 81.37%, respectively. Specific factors such as Barcelona Clinic Liver Cancer (BCLC) Classification B-stage, early neutrophil-to-lymphocyte ratio response, and early alpha-fetoprotein response (> 20% decrease) correlated with superior OS and PFS. The triple therapy exhibited promising efficacy, particularly in BCLC B-stage disease, with prognostic markers aiding in patient stratification. Acknowledging the retrospective nature of the study design, future research should address this limitation and incorporate longer follow-up periods for a comprehensive evaluation of long-term outcomes.

Keywords: Hepatocellular carcinoma; Transarterial chemoembolization; Lenvatinib; Programmed cell death protein-1 inhibitors; Unresectable hepatocellular carcinoma

Core Tip: Transarterial chemoembolization (TACE) combined with lenvatinib and programmed cell death protein-1 (PD-1) inhibitors presents an encouraging therapeutic approach for unresectable hepatocellular carcinoma (HCC). This triple therapy demonstrates well-tolerated outcomes with a median overall survival of 26.43 months and a median progression-free survival of 10.07 months. Notably, patients with Barcelona Clinic Liver Cancer B-stage, exhibiting early neutrophil-to-lymphocyte ratio and alpha-fetoprotein responses, show superior clinical outcomes. Understanding these predictive factors can guide treatment decisions and enhance the efficacy of TACE/lenvatinib/PD-1 therapy in unresectable HCC.