The short-term efficacy of lenvatinib combined with transcatheter arterial chemoembolization and xindilimumab in the treatment of hepatocellular carcinoma
10.3760/cma.j.cn115455-20240930-00826
- VernacularTitle:仑伐替尼联合肝动脉化疗栓塞术及信迪利单抗对肝癌治疗的近期疗效
- Author:
Jingui WANG
1
;
Wuhan ZHOU
1
;
Dongxing CHEN
1
;
Jiafei CHEN
1
;
Yixian GUO
1
Author Information
1. 莆田市第一医院肝胆胰脾外科，莆田 351100
- Publication Type:Journal Article
- Keywords:
Hepatocellular carcinoma;
Transcatheter arterial chemoembolization;
Lenvatinib;
Xindilimumab
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(5):440-447
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the short-term efficacy of lenvatinib combined with transcatheter arterial chemoembolization (TACE) and xindilimumab in the treatment of hepatocellular carcinoma.Methods:A prospective, randomized, controlled study was conducted to divide 140 patients with hepatocellular carcinoma admitted to the First Hospital of Putian City from January 2020 to December 2023. The patients were divided into two groups by random number table method, with 70 cases in each group. The control group was treated with lenvatinib after TACE, and the observation group was treated with lenvatinib + xindilimumab after TACE. The patients were followed up for 6 months, and the number of TACE treatment in the two groups was recorded. The clinical efficacy, serum nuclear factor-κB (NF-κB), hypoxia-inducible factor-1α (HIF-1α), alpha-fetoprotein (AFP) levels, tumor blood supply diameter and drug side effects during treatment were compared between the two groups at 4 weeks and 6 months after TACE treatment.Results:There was no statistical significant difference in the number of TACE treatments between the two groups ( P>0.05). At 4 weeks of treatment, compared with the control group, the objective response rate (ORR) and disease control rate (DCR) of the observation group were significantly increased: 74.29% (52/70) vs. 57.14% (40/70), 92.87% (65/70) vs. 81.43% (57/70) ( P<0.05). After 6 months of treatment, compared with the control group, the observation group showed a significant increase in DCR: 85.71% (60/70) vs. 95.71% (67/70) ( P<0.05). Compared with the control group, the levels of serum NF-κ B, HIF-1α and AFP in the observation group were significantly reduced after 4 weeks and 6 months of treatment: (165.34 ± 40.11) ng/L vs. (187.61 ± 40.62) ng/L, (151.67 ± 36.25) ng/L vs. (165.01 ± 37.12) ng/L; (123.69 ± 20.36) μg/L vs. (148.32 ± 20.38) μg/L, (108.84 ± 20.28) μg/L vs. (121.67 ± 19.29) μg/L; (2 117.02 ± 903.36) μg/L vs. (2 469.79 ± 916.27) μg/L, (1 010.32 ± 422.34) μg/L vs. (1 159. 36 ± 412.01) μg/L ( P<0.05). Compared with the control group, the observation group showed a significant reduction in tumor blood supply diameter after 4 weeks and 6 months of treatment: 3.00 (2.00, 4.00) mm vs. 3.00 (3.00, 4.00) mm, 2.00 (1.00, 3.00) mm vs. 3.00 (2.00, 3.00) mm ( P<0.05) There was no statistically significant difference in the incidence of drug toxicity and side effects between the two treatment groups ( P>0.05). Conclusions:The concurrent administration of lenvatinib and xindilimab has been demonstrated to enhance the short-term therapeutic efficacy of TACE in patients with hepatocellular carcinoma. This combination therapy was associated with a significant reduction in serum levels of NF-κB, HIF-1α, and AFP. Additionally, it led to a notable decrease in the diameter of the tumor-feeding arteries. Preliminary safety analysis indicates that this regimen is well-tolerated, with an acceptable safety profile.
