Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 16, 2024; 12(2): 285-292
Published online Jan 16, 2024. doi: 10.12998/wjcc.v12.i2.285
Lenvatinib combined with sintilimab plus transarterial chemoembolization as first-line treatment for advanced hepatocellular carcinoma
Sha-Sha Sun, Xiao-Di Guo, Wen-Dong Li, Jing-Long Chen
Sha-Sha Sun, Xiao-Di Guo, Wen-Dong Li, Jing-Long Chen, Department of Oncology, Capital Medical University Affiliated Beijing Ditan Hospital, Beijing 100015, China
Author contributions: Sun SS and Chen JL designed the experiment; Sun SS and Guo XD collected the data; Guo XD and Li WD analysed data; Sun SS and Chen JL wrote and revised the manuscript.
Supported by Capital Health Development and Scientific Research Special Project, No. 2022-2-2175.
Institutional review board statement: The study was reviewed and approved by Beijing Ditan Hospital Affiliated to Capital Medical University Institutional Review Board (Approval No. 014-01).
Informed consent statement: Written informed consent was obtained from every patient prior to treatment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: Jing-Long Chen, MS, Associate Professor, Department of Oncology, Capital Medical University Affiliated Beijing Ditan Hospital, No. 8 Jingshun East Street, Chaoyang District, Beijing 100015, China. hhh540027@126.com
Received: November 20, 2023
Peer-review started: November 20, 2023
First decision: December 5, 2023
Revised: December 13, 2023
Accepted: December 27, 2023
Article in press: December 27, 2023
Published online: January 16, 2024
Abstract
BACKGROUND

Recently, combination therapy has shown a better trend towards improved tumour response and survival outcomes than monotherapy in patients with hepatocellular carcinoma (HCC). However, research on triple therapy [lenvatinib + sintilimab + transarterial chemoembolization (TACE)] as a first-line treatment for advanced HCC is limited.

AIM

To evaluate the safety and efficacy of triple therapy as a first-line treatment for advanced HCC.

METHODS

HCC patients with Barcelona Clinic Liver Cancer stage C treated with triple therapy were enrolled. All patients were treated with lenvatinib every day and sintilimab once every 3 wk. Moreover, TACE was performed every 4-6 wk if necessary. The primary outcome of the study was overall survival (OS). The secondary outcomes were the objective response rate (ORR), disease control rate (DCR), and incidence of adverse events.

RESULTS

Forty HCC patients who underwent triple therapy were retrospectively analysed from January 2019 to January 2022. With a median follow-up of 8.5 months, the 3-, 6-, and 12-mo OS rates were 100%, 88.5%, and 22.5%, respectively. The ORR and DCR were 45% and 90%, respectively. The median progressive free survival and median OS were not reached. Common complications were observed in 76% of the patients (grade 3, 15%; grade 4, 2.5%).

CONCLUSION

Combination therapy comprising lenvatinib, sintilimab and TACE achieved promising outcomes in advanced HCC patients and had manageable effects.

Keywords: Lenvatinib, Sintilimab, Advanced hepatocellular carcinoma, Combination therapy, Tumor response

Core Tip: Currently, advanced hepatocellular carcinoma (HCC) has entered the era of combination therapy. Combination therapy has shown better trend in tumor response and survival outcomes and most combination therapy were dual therapies. The research of triple therapy as first-line treatment for advanced HCC is limited. The purpose of this study was to evaluate the safety and clinical efficacy of triple therapy (lenvatinib + sintilimab + transarterial chemoembolization) in HCC patients with Barcelona Clinic Liver Cancer stage C. We found triple therapy achieved a promising outcome in advanced HCC patients and had manageable effects.