The use of portal vein embolization combined with lenvatinib and a PD-1 inhibitor to treat patients with initially unresectable hepatocellular carcinoma
10.3760/cma.j.cn113884-20211014-00332
- VernacularTitle:在接受仑伐替尼联合PD-1抗体治疗的不可切除肝细胞癌患者肝切除术前行门静脉栓塞术的研究
- Author:
Bin XU
1
;
Xiaolong LI
;
Xiaodong ZHU
;
Cheng HUANG
;
Yinghao SHEN
;
Xudong QU
;
Meiling LI
;
Jinjin ZHU
;
Zhaoyou TANG
;
Jian ZHOU
;
Jia FAN
;
Huichuan SUN
Author Information
1. 复旦大学附属中山医院肝肿瘤外科，上海 200032
- Keywords:
Carcinoma, hepatocellular;
Hepatectomy;
Portal vein embolization;
Lenvatinib;
Programmed death-1 antibody
- From:
Chinese Journal of Hepatobiliary Surgery
2022;28(1):21-27
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the safety and treatment outcomes of portal vein embolization (PVE) combined with lenvatinib plus an anti-programmed death-1(PD-1) antibody to treat patients with initially unreasectable hepatocellular carcinoma (uHCC).Methods:This study retrospectively analyzed the data of six patients with uHCC who received first-line combined systemic therapy with lenvatinib plus an anti-PD-1 antibody, and then underwent pre-hepatectomy PVE at the Department of Liver Surgery at Zhongshan Hospital, Fudan University from May 2019 to November 2020. All enrolled patients were males, aged (54.6±6.2) (ranged 46 to 63) years. Tumor response and liver volume were evaluated by medical imagings once every 2 months (±2 weeks) and evaluated using the Response Evaluation Criteria in Solid Tumours (version 1.1). Patients were followed-up by outpatient interviews or by phone calls to record their survival and tumor outcome status.Results:Three of the six enrolled patients had Barcelona Clinic Liver Cancer stage A and three had stage B disease. One patient achieved a partial response and five patients had stable diseases. The mean ± s. d. future liver remnant (FLR) percentage was (29.0±8.9) % before PVE and the combination therapy, and was (41.3±10.8) % before the last evaluation for liver surgery ( t=10.79, P<0.001). Hepatectomy was carried out in five patients, and one patient who failed to develop significant FLR hypertrophy did not undergo hepatectomy. Grade B post-hepatectomy liver failure and major postoperative complications (i.e. pleural effusion requiring additional percutaneous drainage) occurred in one patient. After a median post-operative follow-up of 4.5 (range: 1.0-12.3) months, all five patients were alive and were tumor free. Conclusion:PVE followed by hepatectomy is feasible in a uHCC patients receiving systemic therapy with lenvatinib and an anti-PD-1 antibody.
