ORIGINAL RESEARCH article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1639515
This article is part of the Research TopicBeyond Tumor Cell Killing: Unraveling the Multifaceted Impact of Antitumor Therapies on the Tumor MicroenvironmentView all articles
Efficacy and Safety Analysis of Transarterial Chemoembolization Combined with Tyrosine Kinase Inhibitors and Immune Checkpoint Inhibitors with or without Microwave Ablation for Unresectable Hepatocellular Carcinoma: A Retrospective, Multicenter, Case-control Study
Provisionally accepted
- 1Shandong Provincial Qianfoshan Hospital, Jinan, China
- 2Shandong First Medical University Cancer Hospital, Jinan, China
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Objective: To evaluate the efficacy and safety of transarterial chemoembolization (TACE) combined with tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) with or without microwave ablation (MWA) for unresectable hepatocellular carcinoma (uHCC). Materials and Methods: This retrospective study comprised 220 patients with uHCC who underwent TACE combined with a TKI and ICI with MWA (Group A: 105 patients (median age, 60 ± 10 years) and 82 (78.1%) were men) or without MWA (Group B: 115 patients (median age, 58.35 ± 10.27 years) and 97 (84.4%) were men) at multiple centers in China. The overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and safety were compared between the two groups. Results: The OS, PFS, and ORR in Group A were significantly higher than those in Group B (OS, 21.30 ± 8.25 vs. 15.49 ± 7.41 months, p < 0.0001; PFS, 14.29 ± 6.34 vs. 7.15 ± 4.53 months, p < 0.0001; ORR, 66.7% [70/105] vs. 31.3% [36/115], p < 0.0001). The multivariable Cox regression analysis revealed that the combination of MWA and a more favorable tumor response were significantly associated with improved OS (hazard ratio, 0.5261; 95% confidence interval, 0.3839–0.7182; p = 0.0005 and hazard ratio, 0.5770; 95% confidence interval, 0.4209–0.7886; p = 0.0016). Grade 3 or 4 adverse events occurred in 30/105 (28.6%) and 29/115 (25.2%) patients in Groups A and B, respectively. Conclusion: The combination therapy (TACE + TKIs and ICIs) with MWA showed higher safety and significantly better OS, PFS, and ORR for uHCC than that without MWA.
Keywords: Hepatocellular Carcinoma, Microwave ablation, Transarterial chemoembolization, Immunotherapy, Combined Modality Therapy
Received: 02 Jun 2025; Accepted: 27 Aug 2025.
Copyright: © 2025 Wang, Xu, Du, Xue, Li, Li, Wei and Ye. 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: Xin Ye, Shandong Provincial Qianfoshan Hospital, Jinan, China
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