Transarterial chemoembolization combined with atezolizumab plus bevacizumab versus transarterial chemoembolization combined with lenvatinib plus sintilimab as first-line therapy for advanced hepatocellular carcinoma.
Year: 2025
Type: conference-abstract
Abstract: e16223 Background: Transarterial chemoembolization (TACE) combined with immunotherapy and anti-angiogenic therapy as first-line treatment for advanced hepatocellular carcinoma (HCC) ,demonstrating a promising option. To compare the efficacy and safety of TACE combined with Atezolizumab Plus Bevacizumab (TACE-Ate-Bev) or TACE combined with lenvatinib plus Sintilimab(TACE-Len-Sin) as first-line treatments for advanced HCC. Methods: We assessed overall survival (OS), progression-free survival (PFS), objective response rate(ORR), and adverse events between the TACE-Ate-Bev group (n = 108) and the TACE-Len-Sin group (n = 160) as first-line therapy for advanced HCC. Inverse probability of treatment weighting was employed to minimize bias. Efficacy was evaluated using RECIST 1.1 and mRECIST criteria. Results: After IPTW, the TACE-Ate-Bev group significantly extended the median overall survival (mOS) and median progression-free survival (mPFS) compared to theTACE-Len-Sin group (mOS: 27.9 months vs. 17.03 months, P < 0.001; mPFS: 13.06 months vs. 8.23months, P < 0.001). A higher ORR was observed in TACE-Ate-Bev group, by either RECIST v1.1 or modified RECIST (37.03% vs 33.13%；50.0% vs 33.73%). Grade ≥3 adverse events occurred in 18 patients (16.7%) in TACE-Ate-Bev group and 28 patients (17.5%) in TACE-Len-Sin group.The incidence of gastrointestinal bleeding (GB) was significantly higher in the TACE-Ate-Bev group compared to the TACE-Len-Sin group (10.8% vs. 6.3%). Notably, GB was significantly more frequent in patients with portal hypertension (PHT) compared to those without, in both the TACE-Bev-Ate group (28.2% vs. 6.8%, p < 0.001) and the TACE-Len-Sin group (24.5% vs. 3.2%, p < 0.001). Conclusions: TACE-Ate-Bev demonstrated superior OS and PFS compared to TACE-Len-Sin as first-line treatment for advanced HCC, with an acceptable safety. Management of PHT in patients with advanced HCC is critical to optimizing patient outcomes.
Source: Journal of Clinical Oncology
Authors: Ningning Zhang, Yawei Du, Yuexi Yu, Qiang Wu, Wei Bai, Wei Zhang, Shuwen Zhang, Wenwen Zhu, Hao Yu, Xuanchen Liu, Ming Luo, Huiru Liu, Yiyan Zhang, Kaipeng Liu, Yiming Huo, Guohong Han, Haipeng Yu, Jihui Hao, Wei Lu
Language: English
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4410814214