AUTHOR=Lin Long-Wang , Ke Kun , Yan Le-Ye , Chen Rong , Huang Jing-Yao 

TITLE=Efficacy and safety of hepatic artery infusion chemotherapy combined with tyrosine kinase inhibitors plus programmed death-1 inhibitors for hepatocellular carcinoma refractory to transarterial chemoembolization

JOURNAL=Frontiers in Oncology

VOLUME=Volume 13 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2023.1178428

DOI=10.3389/fonc.2023.1178428

ISSN=2234-943X

ABSTRACT=Background: The subsequent therapy for hepatocellular carcinoma (HCC) patients with refractory to transarterial chemoembolization (TACE) is still controversial. This study was performed to evaluate the efficacy and safety of combination therapy comprising hepatic artery infusion chemotherapy (HAIC), lenvatinib, and programmed death-1 inhibitors relative to HAIC combined with lenvatinib.
Methods: We analyzed the data of HCC patients with refractory to TACE from June 2017 to July 2022 in this single-center retrospective study. Primary study outcomes were overall survival (OS) and progression-free survival (PFS), while the secondary outcomes were objective response rate (ORR) disease control rate (DCR), and treatment-related adverse events.
Results: We enrolled 149 patients finally, including 75 patients who received HAIC combined with lenvatinib plus PD-1 therapy (HAIC+L+P group), and 74 patients who received HAIC combined with lenvatinib (HAIC+L group). The median OS in the HAIC+L+P group (16.0; 95% CI: 13.6~18.3 months) was significantly higher compared to the HAIC+L group (9.0; 95% CI: 6.5~11.4 months) (P = 0.002), while the median PFS in the HAIC+L+P group (11.0; 95% CI: 8.6~13.3 months) was significantly higher compared to HAIC+L group (6.0; 95% CI: 5.0~6.9 months) (P < 0.001). Significant between-group differences in DCR (P = 0.027) were found. Moreover, the percentage of patients with hypertension in the HAIC+L+P group was significantly higher compared to the HAIC+L group (28.00% vs. 13.51%, P = 0.029).
Conclusions: A combination therapy of HAIC, lenvatinib, and programmed death-1 inhibitor significantly improved oncologic response and prolonged survival duration, showing better survival prognosis for HCC patients with refractory toTACE.