Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Sep 27, 2024; 16(9): 2829-2841
Published online Sep 27, 2024. doi: 10.4240/wjgs.v16.i9.2829
Combined transarterial chemoembolization and tislelizumab for patients with unresectable hepatocellular carcinoma
Bin-Bin Tan, Ying Fu, Ming-Hua Shao, Hai-Lei Chen, Ping Liu, Chao Fan, Hui Zhang
Bin-Bin Tan, Ming-Hua Shao, Hai-Lei Chen, Hui Zhang, Department of Hepatobiliary Surgery, First Affiliated Hospital of Third Military Medical University (Army Medical University), Chongqing 400038, China
Ying Fu, Ping Liu, Chao Fan, Department of Hepatobiliary Surgery, First Affiliated Hospital of Third Military Medical University (Army Medical University), Jiangbei Area (The 958th Hospital of Chinese People's Liberation Army), Chongqing 400020, China
Author contributions: Shao MH and Tan BB carried out the studies, participated in collecting data, and drafted the manuscript. Chen HL, Liu P and Fan C performed the statistical analysis and participated in its design. Zhang H and Fu Y participated in acquisition, analysis, or interpretation of data and draft the manuscript. All authors read and approved the final manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of the First Affiliated Hospital of the Army Medical University.
Informed consent statement: The requirement for informed consent was waived due to the retrospective nature of this study.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
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: Hui Zhang, BSc, Doctor, Department of Hepatobiliary Surgery, First Affiliated Hospital of Third Military Medical University (Army Medical University), No. 30 Gaotanyan Main Street, Shapingba Distirct, Chongqing 400038, China. 13637912611@163.com
Received: February 22, 2024
Revised: July 11, 2024
Accepted: August 1, 2024
Published online: September 27, 2024
Processing time: 209 Days and 5.9 Hours
Abstract
BACKGROUND

Hepatocellular carcinoma (HCC) often presents as unresectable, necessitating effective treatment modalities. Combining transarterial chemoembolization (TACE) with immunotherapy and targeted therapy has shown promise, yet real-world evidence is needed.

AIM

To investigate effectiveness and safety of TACE with tislelizumab ± targeted therapy for unresectable HCC in real-world setting.

METHODS

This retrospective study included patients with unresectable HCC receiving combined treatment of TACE and tislelizumab. The clinical outcomes included progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and disease control rate (DCR). All patients were evaluated according to the mRECIST criteria. The adverse event (AE) was also assessed.

RESULTS

In this study of 56 patients with median follow-up of 10.9 months, 7 had previous immunotherapy. Tislelizumab was administered before TACE in 21 (37.50%) and after in 35 (62.50%) patients, with 91.07% receiving concurrent targeted therapy. Median PFS was 14.0 (95%CI: 7.0-18.00) months, and OS was 28 (95%CI: 2.94-53.05) months. Patients with prior immunotherapy had shorter PFS (6 vs. 18 months, P = 0.006). Overall ORR and DCR were 82.14% and 87.50%. Grade ≥ 3 treatment-related AEs included increased alanine aminotransferase (8.93%), aspartate aminotransferase (10.71%), and total bilirubin (3.57%).

CONCLUSION

The combination of TACE and tislelizumab, with or without targeted therapy, demonstrated promising efficacy and safety in unresectable HCC, especially in immunotherapy-naive patients, warranting further prospective validation studies.

Keywords: Hepatocellular carcinoma; Transarterial chemoembolization, Therapeutic; Immunotherapy; Prognosis

Core Tip: Combining transarterial chemoembolization with tislelizumab ± targeted therapy shows promise for treating unresectable hepatocellular carcinoma (HCC). In this real-world study of 56 cases, median progression-free survival (PFS) and overall survival were 14.0 and 28 months, respectively. Notably, individuals with prior immunotherapy had shorter PFS. The approach demonstrated high objective response rate and disease control rate, with manageable adverse events. These findings support further investigation and validate the potential of this combination therapy in HCC management, especially in immunotherapy-naive patients.