PMID- 35530353 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220716 IS - 2234-943X (Print) IS - 2234-943X (Electronic) IS - 2234-943X (Linking) VI - 12 DP - 2022 TI - Efficacy and Safety of TACE Combined With Lenvatinib Plus PD-1 Inhibitors Compared With TACE Alone for Unresectable Hepatocellular Carcinoma Patients: A Prospective Cohort Study. PG - 874473 LID - 10.3389/fonc.2022.874473 [doi] LID - 874473 AB - PURPOSE: To compare the efficacy and safety of the combination of transcatheter arterial chemoembolization (TACE), Lenvatinib, and programmed cell death protein-1 (PD-1) inhibitors (combination group) with TACE (TACE group) in the treatment of patients with unresectable hepatocellular carcinoma (uHCC). METHODS: We consecutively enrolled 110 patients with uHCC in this prospective cohort study, with 56 patients receiving combination treatment and 54 patients receiving TACE from November 2017 to September 2020. The differences in tumor response, survival benefit, and adverse events (AEs) were compared between the two groups. Factors affecting survival were identified via Cox regression analysis. RESULTS: Compared with the TACE group, the combination group had a higher objective response rate (ORR) (67.9% vs. 29.6%, p < 0.001), longer median progression-free survival (mPFS) (11.9 vs. 6.9 months, P = 0.003) and overall survival (mOS) (23.9 vs. 15.3 months, p < 0.001). Multivariate analysis showed that the neutrophil-to-lymphocyte ratio (NLR) and the treatment option were independent factors associated with the PFS and OS. Further subgroup analysis showed that patients with low NLR ( 3.11). There were no unexpected toxicities in the combination group. CONCLUSION: Compared with TACE, the combination treatment demonstrated an improved clinical efficacy and manageable safety profile in patients with uHCC. Combination treatment showed better therapeutic efficacy in patients with low NLR; therefore, this ratio could be used to identify patients who will benefit from this treatment. CI - Copyright (c) 2022 Qu, Zhang, Wu, Meng, Pan, Fang, Hu, Zhang, Wang, Wei and Wu. FAU - Qu, Shuping AU - Qu S AD - Department of Hepatic Surgery, Third Affiliated Hospital of Second Military Medical University, Shanghai, China. FAU - Zhang, Xiaobing AU - Zhang X AD - Department of Hepatic Surgery, Third Affiliated Hospital of Second Military Medical University, Shanghai, China. FAU - Wu, Yutian AU - Wu Y AD - Department of Hepatic Surgery, The First Hospital of Putian, Putian, China. FAU - Meng, Yan AU - Meng Y AD - Tumor Immunology and Gene Therapy Center, Third Affiliated Hospital of Second Military Medical University, Shanghai, China. FAU - Pan, Hongyu AU - Pan H AD - Department of Hepatic Surgery, Third Affiliated Hospital of Second Military Medical University, Shanghai, China. FAU - Fang, Qiang AU - Fang Q AD - Department of Hepatic Surgery, Third Affiliated Hospital of Second Military Medical University, Shanghai, China. FAU - Hu, Lei AU - Hu L AD - Department of Hepatic Surgery, Third Affiliated Hospital of Second Military Medical University, Shanghai, China. FAU - Zhang, Jin AU - Zhang J AD - Department of Hepatic Surgery, Third Affiliated Hospital of Second Military Medical University, Shanghai, China. FAU - Wang, Ruoyu AU - Wang R AD - Department of Hepatic Surgery, Third Affiliated Hospital of Second Military Medical University, Shanghai, China. FAU - Wei, Lixin AU - Wei L AD - Tumor Immunology and Gene Therapy Center, Third Affiliated Hospital of Second Military Medical University, Shanghai, China. FAU - Wu, Dong AU - Wu D AD - Department of Hepatic Surgery, Third Affiliated Hospital of Second Military Medical University, Shanghai, China. LA - eng PT - Journal Article DEP - 20220421 PL - Switzerland TA - Front Oncol JT - Frontiers in oncology JID - 101568867 PMC - PMC9068979 OTO - NOTNLM OT - hepatocellular carcinoma OT - lenvatinib OT - neutrophil-to-lymphocyte ratio OT - programmed cell death-1 inhibitor OT - transcatheter arterial chemoembolization COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The handling editor JY declared a shared parent affiliation with the authors SQ, XZ, YM, HP, QF, LH, JZ, RW, LW, and DW at the time of review. EDAT- 2022/05/10 06:00 MHDA- 2022/05/10 06:01 PMCR- 2022/01/01 CRDT- 2022/05/09 04:21 PHST- 2022/02/12 00:00 [received] PHST- 2022/03/29 00:00 [accepted] PHST- 2022/05/09 04:21 [entrez] PHST- 2022/05/10 06:00 [pubmed] PHST- 2022/05/10 06:01 [medline] PHST- 2022/01/01 00:00 [pmc-release] AID - 10.3389/fonc.2022.874473 [doi] PST - epublish SO - Front Oncol. 2022 Apr 21;12:874473. doi: 10.3389/fonc.2022.874473. eCollection 2022.