Efficacy and safety of hepatic arterial infusion chemotherapy combined with lenvatinib and sequential ablation in the treatment of advanced hepatocellular carcinoma

Abstract

Purpose Evaluate the efficacy and safety of triple therapeutic method (Hepatic Aarterial Infusion Chemotherapy—HAIC, lenvatinib and sequential ablation) in the treatment for Advanced Hepatocellular carcinoma (Ad‐HCC). Materials and Methods From November 2018 to June 2021, data from 150 consecutive Ad‐HCC patients were collected. All patients received HAIC combined with lenvatinib (H‐L group, n = 97) or HAIC combined with lenvatinib and sequential ablation (H‐L‐A group, n = 53). Complications, overall survival (OS), progression‐free survival (PFS) and intrahepatic progression‐free survival (IPFS) were compared between both groups. Results No significant differences of baseline characteristics were found between groups. The time of median follow‐up was 17.8 months (range, 6.8, 37.6 months). In comparison to the H‐L group, the H‐L‐A group patients showed significantly longer median OS (>30 months vs 13.6 months, respectively; p = 0.010), PFS (12.8 vs. 5.6 months, respectively; p < 0.001), and IPFS (14.6 vs. 6.8 months, respectively; p = 0.002). According to the results from uni‐ and multivariable analyses, we considered α‐fetoprotein and treatment modality as two survival independent prognostic factors. No significant change of the complication incidences was observed between H‐L group and H‐L‐A group (12.4% vs. 11.3%, p = 0.890). Conclusion Compared to HAIC combined with lenvatinib only, HAIC combined with lenvatinib and sequential ablation was safer and more effective, improving survival outcomes of Ad‐HCC patients. A prospective study will be designed validate the retrospective results.

Efficacy and safety of transarterial chemoembolization plus lenvatinib in the treatment of advanced hepatocellular carcinoma: A meta-analysis

“…Seven studies [9,10,13–16,18] provided 6-month, 12-month, and 18-month PFS rate data, of which 3 studies [9,14,18] were TACE plus lenvatinib versus TACE alone, and the other 4 studies [10,13,15,16] were TACE plus lenvatinib versus lenvatinib alone. The results of the heterogeneity test showed that the heterogeneity among the studies was small ( P > .1, I 2 < 50%).…”

“…A total of 573 articles were retrieved, and 244 repeated articles were excluded by title, year of publication, and author information. Then after reading abstracts and full-text screening, 311 articles that did not meet the criteria were excluded and finally included 18 studies [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] (Fig. 1).…”

“…Seven studies [9,10,[13][14][15][16]18] provided 6-month, 12-month, and 18-month PFS rate data, of which 3 studies [9,14,18] were TACE plus lenvatinib versus TACE alone, and the other 4 studies [10,13,15,16] were TACE plus lenvatinib versus lenvatinib alone.…”

“…Ten studies [9][10][11][12][13][14][15][16]18,25] provided 6-month OS rate data, of which 5 studies [9,11,14,18,25] were TACE plus lenvatinib versus TACE alone, and the other 5 studies [10,12,13,15,16] were TACE plus lenvatinib versus lenvatinib alone. Based on the heterogeneity test results (P = .95, I 2 = 0%; P = .52, I 2 = 0%).…”

“…See Figure 5A. The ten and 9 included studies reported that 12-month [9][10][11][12][13][14][15][16]18,25] and 18-month [9][10][11][12][13][14][15][16]18] OS rates, respectively. The results of the heterogeneity test showed that the heterogeneity among the studies was small (P > .1, I 2 < 50%).…”