Efficacy and safety of TACE combined with lenvatinib and PD-1 inhiti-bors in the treatment of hepatocellular carcinoma with portal vein tumor thrombus
10.12092/j.issn.1009-2501.2025.05.008
- VernacularTitle:TACE联合仑伐替尼及PD-1抑制剂治疗伴门静脉癌栓的肝细胞癌患者的疗效及安全性
- Author:
Xu LANG
1
;
Boyu LIU
1
Author Information
1. 天津医科大学总医院医学影像科,天津 300052
- Publication Type:Journal Article
- Keywords:
hepatocellular carcinoma;
portal vein tumor thrombus;
TACE;
lenvatinib;
PD-1 inhitibors;
efficacy;
safety
- From:
Chinese Journal of Clinical Pharmacology and Therapeutics
2025;30(5):648-656
- CountryChina
- Language:Chinese
-
Abstract:
AIM:To investigate the efficacy and safety of TACE combined with lenvatinib and PD-1 inhitibors for hepatocellular carcinoma(HCC)with portal vein tumor thrombus(PVTT).METHO DS:HCC patients with PVTT who received TACE combined with lenvatinib and PD-1 inhitibors as first-line ther-apy in clinical practice were included in this study retrospectively.Therapeutic outcomes of this regi-men were calculated based on the target lesions evaluated using mRECIST criteria.Additionally,all the subjects were followed up regularly to obtain the prognostic outcomes.Safety profile observed during the combination therapy was collected and documented specifically.Log-rank test was used for exploratory analysis between prognosis and base-line characteristics,and Cox regression analysis was adopted for multivariate analysis.RESULTS:A total of 67 HCC patients with PVTT who received TACE combined with lenvatinib and PD-1 inhitibors were included in this study ultimately,4 patients achieved complete response,30 patients were par-tial response,25 patients were stable disease,5 pa-tients were disease progression and 3 patients were not available for the response outcomes.Therefore,the objective response rate(ORR)of this regimen was 50.7％and disease control rate(DCR)was 88.1％.Prognostic data suggested that the me-dian progression free survival(PFS)of the 67 HCC patients with PVTT was 9.3 months(95％CI:5.85-12.75),and the median overall survival(OS)was 24.4 months(95％CI:19.11-29.69).Safety profile highlighted that a total of 65 patients experienced adverse reactions regardless of grade when re-ceived TACE combined with lenvatinib and PD-1 in-hitibors(97.0％),among whom,a total of 34 pa-tients were deemed as grade ≥3 adverse reactions(50.7％).The most common adverse reactions were hypertension,fatigue,abnormal liver function,nau-sea and vomiting and diarrhea.CONCLUSION:TACE combined with lenvatinib and PD-1 inhitibors as first-line therapy for HCC with PVTT demonstrated encouraging efficacy and acceptable safety profile.
