Efficacy and safety of lenvatinib combined with sintilimab versus atezolizumab combined with bevacizumab in treatment of unresectable hepatocellular carcinoma
- VernacularTitle:仑伐替尼联合信迪利单抗与阿替利珠单抗联合贝伐珠单抗治疗不可切除肝细胞癌的效果及安全性分析
- Author:
Jianying WEI
1
;
Wei SUN
1
;
Xiaomin LIU
1
;
Minghua YU
1
;
Wendong LI
1
;
Jinglong CHEN
1
Author Information
- Publication Type:Journal Article
- Keywords: Carcinoma， Hepatocellular; Lenvatinib; Sintilimab; Atezolizumab; Bevacizumab
- From: Journal of Clinical Hepatology 2026;42(6):1335-1341
- CountryChina
- Language:Chinese
- Abstract: ObjectiveTo investigate the efficacy and safety of lenvatinib combined with sintilimab versus atezolizumab combined with bevacizumab in patients with unresectable hepatocellular carcinoma （uHCC）， aims to provide real-world evidence for clinical personalized treatment. MethodsA retrospective analysis was performed for 78 patients with uHCC who were admitted to Beijing Ditan Hospital， Capital Medical University， from January 1， 2023， to May 31， 2025， and according to the treatment modality， they were divided into lenvatinib+sintilimab group （L+S group with 49 patients） and atezolizumab+bevacizumab group （A+T group with 29 patients）. The primary endpoints were progression-free survival （PFS） and overall survival （OS）， and the secondary endpoints included objective response rate （ORR）， disease control rate （DCR）， and the incidence rate of adverse events. The independent-samples t test was used for comparison of normally distributed continuous data between groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups； the chi-square test was used for comparison of categorical data between groups. The Kaplan-Meier method was used for survival analysis， and the log-rank test was used for comparison between groups. ResultsThe 78 patients had a median PFS of 9 months and a median OS of 15 months. The median PFS was 11 months in the L+S group and 7 months in the A+T group， with no significant difference between the two groups （χ2=0.247， P=0.619）； the median OS was 19 months in the L+S group and 12 months in the A+T group， with a significant difference between the two groups （χ2=6.565， P=0.010）. There were no significant differences between the two groups in complete remission， partial remission， stable disease， disease progression， DCR， and ORR （all P>0.05）. The L+S group had a significantly higher incidence rate of adverse events than the A+T group （95.9% vs 75.9%， P=0.007）， and there was a significant difference in the incidence rate of grade ≥3 adverse events between the L+S group and the A+T group （65.3% vs 34.5%， P=0.008）. ConclusionCompared with atezolizumab combined with bevacizumab， lenvatinib combined with sintilimab can improve the OS of patients with uHCC， while atezolizumab combined with bevacizumab has a better safety profile.
