Efficacy of lenvatinib combined with sequential transarterial chemoembolization for primary hepatocellular carcinoma and the effects on serum basic fibroblast growth factor and vascular endothelial growth factor

Abstract

Objective: The aim of this research was to investigate the therapeutic efficacy of lenvatinib combined with sequential transarterial chemoembolization (TACE) on primary hepatocellular carcinoma (HCC) and the effects on serum basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF).Method: A total of 104 patients with primary HCC, admitted to People’s Hospital of Leshan from April 2018 to January 2021, were selected as the study subjects and were divided into the TACE-LEN group (n = 53) who were treated with lenvatinib combined with sequential TACE and the TACE group (n = 51) who were treated with TACE alone, according to the appropriate treatment modalities. The clinical efficacy 8 weeks after treatment; the serum levels of total bilirubin, conjugated bilirubin, and alanine aminotransferase (ALT); the prothrombin time (PT); the indocyanine green retention rate at 15 min (ICGR15); and the serum bFGF and VEGF levels before treatment and at 8 weeks after treatment were compared between the two groups. The incidence of adverse events and the survival rates at 18 months were also recorded for both groups. COX regression analysis was used to analyze the risk factors affecting the survival of patients.Results: Eight weeks after treatment, the objective response rate was higher in the TACE-LEN group than in the TACE group (77.36% vs. 56.36%, p < 0.05), but there were no statistically significant differences in the bilirubin and ALT levels, the PT, and the ICGR15 between the two groups (p > 0.05). The serum bFGF and VEGF levels post-therapeutic were lower in the TACE-LEN group than in the TACE group (p < 0.05). The differences in the incidence of postoperative adverse events and the survival rate within 6 months were not statistically significant between the two groups (p > 0.05). In addition, the survival rates within 12 and 18 months after treatment were higher in the TACE-LEN group than in the TACE group than in the TACE group (81.1% vs. 64.7%, 69.8% vs. 49.1%, p < 0.05). ICG-R15 and treatment regimen are risk factors for survival.Conclusion: The worse the liver reserve is, the worse the prognosis is. The combination of TACE and lenvatinib showed better efficacy and longer survival than TACE monotherapy for HCC patients and reduced the levels of bFGF and VEGF.

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

“…See Figure 6 A. Five other studies [ 11 , 17 , 19 , 21 , 24 ] reported VEGF expression levels in serum before and after treatment in experimental and control groups. Based on the results of the heterogeneity test ( P = .02, I 2 = 66%), the results of the random-effects model analysis showed that the experimental group could significantly reduce the level of serum VEGF expression in patients with advanced HCC compared with the control group (SMD = 1.27, 95%CI: 0.87–1.67, P < .00001).…”

“…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).…”

“…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%).…”