Lenvatinib and tislelizumab versus atezolizumab and bevacizumab in combination with TAE-HAIC for unresectable hepatocellular carcinoma with high tumor burden: a multicenter retrospective cohort study
Abstract Background Systemic and locoregional combination therapy has demonstrated promising outcomes for unresectable hepatocellular carcinoma (HCC); However, the best combination option remains unknown. This study compared the efficacy and safety of lenvatinib and tislelizumab versus atezolizumab...
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Springer
2025-02-01
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| Series: | Cancer Immunology, Immunotherapy |
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| Online Access: | https://doi.org/10.1007/s00262-025-03942-3 |
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| author | Hongjie Cai Song Chen Shuangyan Tang Yi Xiao Feng Shi Zhiqiang Wu Ping Ma Huanwei Chen Wenquan Zhuang Wenbo Guo |
| author_facet | Hongjie Cai Song Chen Shuangyan Tang Yi Xiao Feng Shi Zhiqiang Wu Ping Ma Huanwei Chen Wenquan Zhuang Wenbo Guo |
| author_sort | Hongjie Cai |
| collection | DOAJ |
| description | Abstract Background Systemic and locoregional combination therapy has demonstrated promising outcomes for unresectable hepatocellular carcinoma (HCC); However, the best combination option remains unknown. This study compared the efficacy and safety of lenvatinib and tislelizumab versus atezolizumab and bevacizumab in combination with transarterial embolization (TAE) plus hepatic artery infusion chemotherapy (HAIC) for unresectable HCC with high tumor burden. Methods This multicenter retrospective cohort study enrolled treatment-naive patients with unresectable HCC treated with TAE-HAIC plus lenvatinib and tislelizumab (THLP group) or TAE-HAIC plus atezolizumab and bevacizumab (THTA group). The primary endpoint was overall survival (OS). Secondary endpoints included progression-free survival (PFS), tumor response, and adverse events (AEs). Propensity score matching (PSM) was performed to reduce bias. Results Of the 240 patients enrolled, 153 and 51 patients were assigned to the THLP and THTA groups, respectively after PSM (3:1). The THLP group showed a longer median OS (22 months vs. 18.2 months; P = 0.412), whereas the median PFS was longer in the THTA group (8.1 months vs. 7 months; P = 0.723), with statistically insignificant intergroup differences. No statistical differences were observed in objective response rate (RECIST 1.1: 33.9 vs. 31.4%; mRECIST: 77.1% vs. 74.5%; P = 0.635), disease control rate (RECIST 1.1: 88.9% vs. 92.2; mRECIST: 92.2% vs. 94.1%; P = 0.716), and in grade 3/4 AEs. Gastrointestinal hemorrhage rate was significantly higher in the THTA group (9.1% vs. 1.6%; P = 0.007). All AEs were controllable and no treatment-related grade 5 AEs occurred. Conclusions TAE-HAIC plus lenvatinib and tislelizumab or TAE-HAIC plus atezolizumab and bevacizumab showed similar outcomes for unresectable HCC with high tumor burden, and manageable safety. The results need further validation. |
| format | Article |
| id | doaj-art-3b1173b7b71e45c3b8538d63a3b34927 |
| institution | Kabale University |
| issn | 1432-0851 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Springer |
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| series | Cancer Immunology, Immunotherapy |
| spelling | doaj-art-3b1173b7b71e45c3b8538d63a3b349272025-02-02T12:26:21ZengSpringerCancer Immunology, Immunotherapy1432-08512025-02-0174311210.1007/s00262-025-03942-3Lenvatinib and tislelizumab versus atezolizumab and bevacizumab in combination with TAE-HAIC for unresectable hepatocellular carcinoma with high tumor burden: a multicenter retrospective cohort studyHongjie Cai0Song Chen1Shuangyan Tang2Yi Xiao3Feng Shi4Zhiqiang Wu5Ping Ma6Huanwei Chen7Wenquan Zhuang8Wenbo Guo9Department of Interventional Radiology, The First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Minimally Invasive Interventional Therapy, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer CenterDepartment of Radiology, The Eighth Affiliated Hospital of Sun Yat-Sen UniversityCenter of Hepato-Pancreato-Biliary Surgery, The First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Interventional Radiology, Guangdong Provincial People’s HospitalDepartment of Interventional Radiology, The First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Oncology, The Twelfth People’s Hospital of GuangzhouDepartment of Hepatopancreatic Surgery, The First People’s Hospital of FoshanDepartment of Interventional Radiology, The First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Interventional Radiology, The First Affiliated Hospital of Sun Yat-Sen UniversityAbstract Background Systemic and locoregional combination therapy has demonstrated promising outcomes for unresectable hepatocellular carcinoma (HCC); However, the best combination option remains unknown. This study compared the efficacy and safety of lenvatinib and tislelizumab versus atezolizumab and bevacizumab in combination with transarterial embolization (TAE) plus hepatic artery infusion chemotherapy (HAIC) for unresectable HCC with high tumor burden. Methods This multicenter retrospective cohort study enrolled treatment-naive patients with unresectable HCC treated with TAE-HAIC plus lenvatinib and tislelizumab (THLP group) or TAE-HAIC plus atezolizumab and bevacizumab (THTA group). The primary endpoint was overall survival (OS). Secondary endpoints included progression-free survival (PFS), tumor response, and adverse events (AEs). Propensity score matching (PSM) was performed to reduce bias. Results Of the 240 patients enrolled, 153 and 51 patients were assigned to the THLP and THTA groups, respectively after PSM (3:1). The THLP group showed a longer median OS (22 months vs. 18.2 months; P = 0.412), whereas the median PFS was longer in the THTA group (8.1 months vs. 7 months; P = 0.723), with statistically insignificant intergroup differences. No statistical differences were observed in objective response rate (RECIST 1.1: 33.9 vs. 31.4%; mRECIST: 77.1% vs. 74.5%; P = 0.635), disease control rate (RECIST 1.1: 88.9% vs. 92.2; mRECIST: 92.2% vs. 94.1%; P = 0.716), and in grade 3/4 AEs. Gastrointestinal hemorrhage rate was significantly higher in the THTA group (9.1% vs. 1.6%; P = 0.007). All AEs were controllable and no treatment-related grade 5 AEs occurred. Conclusions TAE-HAIC plus lenvatinib and tislelizumab or TAE-HAIC plus atezolizumab and bevacizumab showed similar outcomes for unresectable HCC with high tumor burden, and manageable safety. The results need further validation.https://doi.org/10.1007/s00262-025-03942-3Combination therapyHepatic artery infusion chemotherapyHepatocellular carcinomaSystemic therapyTransarterial embolization |
| spellingShingle | Hongjie Cai Song Chen Shuangyan Tang Yi Xiao Feng Shi Zhiqiang Wu Ping Ma Huanwei Chen Wenquan Zhuang Wenbo Guo Lenvatinib and tislelizumab versus atezolizumab and bevacizumab in combination with TAE-HAIC for unresectable hepatocellular carcinoma with high tumor burden: a multicenter retrospective cohort study Cancer Immunology, Immunotherapy Combination therapy Hepatic artery infusion chemotherapy Hepatocellular carcinoma Systemic therapy Transarterial embolization |
| title | Lenvatinib and tislelizumab versus atezolizumab and bevacizumab in combination with TAE-HAIC for unresectable hepatocellular carcinoma with high tumor burden: a multicenter retrospective cohort study |
| title_full | Lenvatinib and tislelizumab versus atezolizumab and bevacizumab in combination with TAE-HAIC for unresectable hepatocellular carcinoma with high tumor burden: a multicenter retrospective cohort study |
| title_fullStr | Lenvatinib and tislelizumab versus atezolizumab and bevacizumab in combination with TAE-HAIC for unresectable hepatocellular carcinoma with high tumor burden: a multicenter retrospective cohort study |
| title_full_unstemmed | Lenvatinib and tislelizumab versus atezolizumab and bevacizumab in combination with TAE-HAIC for unresectable hepatocellular carcinoma with high tumor burden: a multicenter retrospective cohort study |
| title_short | Lenvatinib and tislelizumab versus atezolizumab and bevacizumab in combination with TAE-HAIC for unresectable hepatocellular carcinoma with high tumor burden: a multicenter retrospective cohort study |
| title_sort | lenvatinib and tislelizumab versus atezolizumab and bevacizumab in combination with tae haic for unresectable hepatocellular carcinoma with high tumor burden a multicenter retrospective cohort study |
| topic | Combination therapy Hepatic artery infusion chemotherapy Hepatocellular carcinoma Systemic therapy Transarterial embolization |
| url | https://doi.org/10.1007/s00262-025-03942-3 |
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