SYSTEMATIC REVIEW article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1586914
This article is part of the Research TopicImmunology and Therapeutic Innovations in Hepatocellular Carcinoma: Exploring Immune Evasion and BeyondView all 5 articles
Efficacy and safety of lenvatinib plus transarterial chemoembolization with or without programmed death-1 inhibitors in the treatment of intermediate or advanced hepatocellular carcinoma: A systematic review and meta-analysis
Provisionally accepted
- Guangxi University of Science and Technology, Liuzhou, China
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Introduction This meta-analysis aimed to evaluate the efficacy and safety of Lenvatinib plus transarterial chemoembolization with or without programmed death-1 inhibitors (PD-1 inhibitors) in the treatment of intermediate or advanced hepatocellular carcinoma (HCC).Four databases (Pubmed, Embase, Web of Science, and Cochrane Library) were searched for studies comparing lenvatinib plus transarterial chemoembolization with PD-1 inhibitors (TACE-L-P) versus Lenvatinib plus transarterial chemoembolization (TACE-L) for intermediate or advanced HCC.Meta-analyses were conducted for progression-free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR), and Grade ≥ 3 treatment-related adverse events (Grade ≥ 3 AEs).The meta-analysis comprised 19 retrospective cohort studies, including of 2002 patients diagnosed with intermediate or advanced HCC. In this cohort, 1011 individuals were administered TACE-L-P, while 991 patients received TACE-L. In comparison to TACE-L, TACE-L-P demonstrated a superior ORR [odds ratio (OR) = 2.38, 95% confidence interval (CI) 1.98 ~2.87, P < 0.00001] and DCR (OR = 3.22, 95% CI, 2.32 ~4.45, P < 0.00001). TACE-L-P showed superior efficacy compared to TACE-L regarding PFS (HR: 0.56, 95%CI 0.50 to 0.62, P<0.0001) and OS (HR: 0.70, 95%CI 0.60 to 0.80, P<0.0001). Regarding safety, the incidence of Grade ≥ 3 AEs was more prevalent in the TACE-L-P group compared to the TACE-L group (OR=1.58, 95% CI: 1.27 ~1.97, P<0.0001).The present meta-analysis present a comparison of the efficacy and safety of TACE-L-P against TACE-L for intermediate or advanced HCC. TACE-L-P enhanced ORR, DCR, PFS, and OS relative to TACE-L. Furthermore, the improved efficacy of TACE-L-P was correlated with a rise in the incidence of Grade ≥ 3 AEs.
Keywords: Hepatocellular Carcinoma, Lenvatinib, PD-1 inhibitor, Transarterial chemoembolization, Progression-free survival, overall survival, Objective response rate, Meta-analysis
Received: 03 Mar 2025; Accepted: 08 Jul 2025.
Copyright: © 2025 Lei, Zhu, Liang, Wang, Zhang, Duan and Liang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xiaochen Zhang, Guangxi University of Science and Technology, Liuzhou, China
Siliang Duan, Guangxi University of Science and Technology, Liuzhou, China
Weiming Liang, Guangxi University of Science and Technology, Liuzhou, China
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