Safety and efficacy of hepatic arterial infusion chemotherapy using second-line lenvatinib plus immune checkpoint inhibitors in the treatment of progressive advanced hepatocellular carcinoma
10.3969/j.issn.1008-794X.2025.03.006
- VernacularTitle:仑伐替尼联合免疫检查点抑制剂二线治疗HAIC后进展性晚期肝细胞癌安全性和有效性
- Author:
Qiming WEI
1
;
Sheng ZHONG
;
Haiming ZHANG
;
Hong ZHANG
;
Fengtao ZHANG
Author Information
1. 510120 广东广州 广州中医药大学第二附属医院(广东省中医院)介入科
- Keywords:
lenvatinib;
immune checkpoint inhibitor;
hepatic arterial infusion chemotherapy;
hepatocellular carcinoma;
progression
- From:
Journal of Interventional Radiology
2025;34(3):261-267
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the safety and efficacy of hepatic arterial infusion chemotherapy(HAIC)using lenvatinib plus immune checkpoint inhibitors(ICI)in the treatment of progressive advanced hepatocellular carcinoma(HCC).Methods The clinical data of 67 patients with HCC of BCLC stage C,who received HAIC treatment at the Guangdong Provincial Hospital of Traditional Chinese Medicine of China from May 2018 to March 2022 and were assessed as in disease progression(PD)status after HAIC treatment,then had to further receive second-line treatment with lenvatinib plus ICI regimen.According to modified Response Evaluation Criteria in Solid Tumors(mRECIST),the tumor responses,including overall survival(OS),progression free survival(PFS),objective response rate(ORR),and disease control rate(DCR),were evaluated.Univariate analysis and multivariate analysis based on the COX proportional hazards regression model were used to determine the prognosis-related risk factors.According to the Common Terminology Criteria for Adverse Events version 5.0(CTCAE 5.0),the treatment-related adverse effects were recorded and evaluated.Results The median OS and median PFS in the 67 patients with HCC of BCLC stage C receiving second-line treatment with lenvatinib plus ICI regimen,who were evaluated as in PD status after first-line HAIC treatment,were 18.4 months and 7.2 months respectively.The ORR and DCR were 22.4％(15/67)and 67.4％(45/67)respectively.Univariate analysis and multivariate analysis showed that Eastern Cooperative oncology Group(ECOG)score and hepatitis B virus(HBV)infection were the independent risk factors affecting OS,while AFP level was an independent risk factor affecting PFS.The main treatment-related adverse reactions included elevation of transaminase level,hypertension,and hyperbilirubinemia.No death occurred during the therapeutic course.Conclusion For patients with HCC of BCLC stage C,who become in PD status after first-line HAIC treatment,second-line treatment with lenvatinib plus ICI regimen carries satisfactory efficacy and its adverse reaction is tolerable.
