PMID- 34453221 OWN - NLM STAT- MEDLINE DCOM- 20220720 LR - 20220721 IS - 1432-1335 (Electronic) IS - 0171-5216 (Print) IS - 0171-5216 (Linking) VI - 148 IP - 8 DP - 2022 Aug TI - Lenvatinib plus TACE with or without pembrolizumab for the treatment of initially unresectable hepatocellular carcinoma harbouring PD-L1 expression: a retrospective study. PG - 2115-2125 LID - 10.1007/s00432-021-03767-4 [doi] AB - PURPOSE: The aim of this retrospective study was to compare the clinical outcomes of pembrolizumab-lenvatinib-transarterial chemoembolization (TACE) versus lenvatinib-TACE sequential therapy in selected populations of Chinese patients with initially unresectable hepatocellular carcinoma (uHCC) harbouring programmed cell death ligand-1 (PD-L1) expression. METHODS: Consecutive patients with initial PD-L1-positive uHCC who received pembrolizumab-lenvatinib-TACE or lenvatinib-TACE sequential therapy were retrospectively identified from three medical institutions during 2016-2020. The primary endpoints included the rate of conversion therapy, defined as converting initially uHCC to hepatectomy, overall survival (OS), and progression-free survival (PFS); secondary endpoint was the frequency of key adverse events (AEs). RESULTS: In total, 220 consecutively recruited patients were retrospectively reviewed, 78 of whom were ineligible according to the current criteria, leaving 142 patients [pembrolizumab-lenvatinib-TACE: n = 70, median age 58 years (range 36-69) and lenvatinib-TACE: n = 72, 57 years (35-68)] who were eligible for the study. The median duration of follow-up was 27 months [95% confidence interval (CI), 26.3-28.7 months]. At the last follow-up, the rate of conversion therapy was 25.7% in the pembrolizumab-lenvatinib-TACE group and 11.1% in the lenvatinib-TACE group (p = 0.025). The median OS was 18.1 months (95% CI 16.5-20.7) in the pembrolizumab-lenvatinib-TACE group versus 14.1 months (95% CI 12.2-16.9) in the lenvatinib-TACE group [hazard ratio (HR) 0.56, 95% CI 0.38-0.83; p = 0.004]. A distinct difference in the median PFS interval between the groups was detected [9.2 months (95% CI 7.1-10.4) in the pembrolizumab-lenvatinib-TACE group vs. 5.5 months (95% CI 3.9-6.6) in the lenvatinib-TACE group (HR 0.60; 95% CI 0.39-0.91; p = 0.006)]. The rates of the key AEs assessed, which were hypertension, nausea, and rash, were higher in the pembrolizumab-lenvatinib-TACE group than in the lenvatinib-TACE group (all p < 0.05). CONCLUSION: Among the selected populations of patients with initial PD-L1-positive uHCC, pembrolizumab-lenvatinib-TACE sequential therapy may have promising antitumour activity, with an acceptable conversion rate and a well-characterized safety profile. CI - (c) 2021. The Author(s). FAU - Chen, Song AU - Chen S AD - Department of Interventional Radiology, The First Affiliated Hospital, Sun Yat-Sen University, No. 58, Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, China. FAU - Wu, Zhiqiang AU - Wu Z AD - Department of Interventional Radiology, The First Affiliated Hospital, Sun Yat-Sen University, No. 58, Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, China. FAU - Shi, Feng AU - Shi F AD - Department of Interventional Radiology, Cancer Center, Guangdong Provincial People's Hospital, Guangdong Provincial Academy of Medical Sciences, No. 106, Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, China. FAU - Mai, Qicong AU - Mai Q AD - Department of Interventional Radiology, Cancer Center, Guangdong Provincial People's Hospital, Guangdong Provincial Academy of Medical Sciences, No. 106, Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, China. FAU - Wang, Liguang AU - Wang L AD - Department of Hepatic Surgery, Foshan First People's Hospital, No. 81, North Lingnan Dadao, Chancheng District, Foshan, 528000, China. FAU - Wang, Fan AU - Wang F AD - Department of Interventional Radiology, The First Affiliated Hospital, Sun Yat-Sen University, No. 58, Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, China. FAU - Zhuang, Wenquan AU - Zhuang W AD - Department of Interventional Radiology, The First Affiliated Hospital, Sun Yat-Sen University, No. 58, Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, China. FAU - Chen, Xiaoming AU - Chen X AD - Department of Interventional Radiology, Cancer Center, Guangdong Provincial People's Hospital, Guangdong Provincial Academy of Medical Sciences, No. 106, Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, China. FAU - Chen, Huanwei AU - Chen H AD - Department of Hepatic Surgery, Foshan First People's Hospital, No. 81, North Lingnan Dadao, Chancheng District, Foshan, 528000, China. FAU - Xu, Bo AU - Xu B AD - Department of Thoracic Surgery, The First Affiliated Hospital, Sun Yat-Sen University, No. 58, Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, China. xubo25@mail.sysu.edu.cn. FAU - Lai, Jiaming AU - Lai J AD - Department of Hepatobiliary-pancreatic Surgery, The First Affiliated Hospital, Sun Yat-Sen University, No. 58, Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, China. FAU - Guo, Wenbo AU - Guo W AUID- ORCID: 0000-0002-1017-4640 AD - Department of Interventional Radiology, The First Affiliated Hospital, Sun Yat-Sen University, No. 58, Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, China. guowenbo@mail.sysu.edu.cn. LA - eng PT - Journal Article DEP - 20210828 PL - Germany TA - J Cancer Res Clin Oncol JT - Journal of cancer research and clinical oncology JID - 7902060 RN - 0 (Antibodies, Monoclonal, Humanized) RN - 0 (B7-H1 Antigen) RN - 0 (Phenylurea Compounds) RN - 0 (Quinolines) RN - DPT0O3T46P (pembrolizumab) RN - EE083865G2 (lenvatinib) SB - IM MH - Adult MH - Aged MH - Antibodies, Monoclonal, Humanized MH - B7-H1 Antigen MH - *Carcinoma, Hepatocellular/drug therapy/pathology MH - *Chemoembolization, Therapeutic MH - Humans MH - *Liver Neoplasms/drug therapy/pathology MH - Middle Aged MH - Phenylurea Compounds MH - Quinolines MH - Retrospective Studies MH - Treatment Outcome PMC - PMC9293824 OTO - NOTNLM OT - Conversion OT - Hepatectomy OT - Hepatocellular carcinoma OT - Lenvatinib OT - Pembrolizumab OT - Transarterial chemoembolization COIS- All authors declare no conflict of interest associated with this manuscript. EDAT- 2021/08/29 06:00 MHDA- 2022/07/22 06:00 PMCR- 2021/08/28 CRDT- 2021/08/28 05:58 PHST- 2021/07/10 00:00 [received] PHST- 2021/08/14 00:00 [accepted] PHST- 2021/08/29 06:00 [pubmed] PHST- 2022/07/22 06:00 [medline] PHST- 2021/08/28 05:58 [entrez] PHST- 2021/08/28 00:00 [pmc-release] AID - 10.1007/s00432-021-03767-4 [pii] AID - 3767 [pii] AID - 10.1007/s00432-021-03767-4 [doi] PST - ppublish SO - J Cancer Res Clin Oncol. 2022 Aug;148(8):2115-2125. doi: 10.1007/s00432-021-03767-4. Epub 2021 Aug 28.