PMID- 37885925 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231028 IS - 2253-5969 (Print) IS - 2253-5969 (Electronic) IS - 2253-5969 (Linking) VI - 10 DP - 2023 TI - Hepatocellular Carcinoma with Radiological Progression: Lenvatinib Plus PD-1 Inhibitor Combined with Microwave Ablation and Synchronous Transarterial Chemoembolization. PG - 1861-1871 LID - 10.2147/JHC.S426308 [doi] AB - PURPOSE: To determine the clinical outcomes of lenvatinib plus PD-1 inhibitor combined with microwave ablation (MWA) and synchronous transarterial chemoembolization (TACE) in patients with progressive hepatocellular carcinoma (pHCC). MATERIALS AND METHODS: This retrospective study enrolled pHCC patients who underwent lenvatinib plus PD-1 inhibitor combined with MWA and TACE (LP-MT) or lenvatinib combined with MWA and TACE (L-MT) from January 2019 to December 2022. Treatment-related adverse events (AEs) were recorded during the follow-up. Progression-free survival (PFS) and overall survival (OS) were the primary outcomes. The prognostic analyses for survival were performed using Cox proportional hazard regression model. RESULTS: In total, 90 eligible patients with pHCC who received combination therapy were included in the study. Among them, 42 patients received LP-MT and 48 patients received L-MT. There were no significant differences in the baseline characteristics between the two groups. Patients who underwent lenvatinib plus PD-1 inhibitor combined with MWA and TACE had better PFS (median, 10.0 vs 7.4 months, P = 0.03) than those who underwent combination therapy without PD-1 inhibitor, although no significant difference was found in OS (median, 22.5 vs 20.0 months, P = 0.19) between the two groups. The disease control rate of LP-MT group was higher than that of L-MT group (88.1% vs 64.6%, P = 0.01), especially in patients with BCLC stage C (89.3% vs 70.0%, P = 0.03). Univariate and multivariate analyses indicated that treatment method and Child-Pugh class were independent prognostic factors for PFS. The AEs of LP-MT group were comparable and tolerable to those of L-MT group (Any grade, 78.6% vs 62.5%, P = 0.10; Grade 3, 23.8% vs 12.5%, P = 0.16). CONCLUSION: Lenvatinib plus PD-1 inhibitor may be slightly superior to lenvatinib alone when combined with local interventional therapy for progressive HCC, especially in patients with BCLC stage C. CI - (c) 2023 Shi et al. FAU - Shi, Qin AU - Shi Q AD - Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China. AD - Shanghai Institution of Medical Imaging, Fudan University, Shanghai, 200032, People's Republic of China. AD - National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China. FAU - Huang, Peng AU - Huang P AD - Shanghai Institution of Medical Imaging, Fudan University, Shanghai, 200032, People's Republic of China. AD - Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China. FAU - Zhang, Zihan AU - Zhang Z AD - Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China. AD - Shanghai Institution of Medical Imaging, Fudan University, Shanghai, 200032, People's Republic of China. AD - National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China. FAU - Zhang, Wen AU - Zhang W AD - Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China. AD - Shanghai Institution of Medical Imaging, Fudan University, Shanghai, 200032, People's Republic of China. AD - National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China. FAU - Liu, Lingxiao AU - Liu L AD - Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China. AD - Shanghai Institution of Medical Imaging, Fudan University, Shanghai, 200032, People's Republic of China. AD - National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China. FAU - Yan, Zhiping AU - Yan Z AD - Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China. AD - Shanghai Institution of Medical Imaging, Fudan University, Shanghai, 200032, People's Republic of China. AD - National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China. LA - eng PT - Journal Article DEP - 20231021 PL - New Zealand TA - J Hepatocell Carcinoma JT - Journal of hepatocellular carcinoma JID - 101674775 PMC - PMC10599250 OTO - NOTNLM OT - PD-1 inhibitor OT - hepatocellular carcinoma OT - lenvatinib OT - microwave ablation OT - radiological progression COIS- All authors declare no conflicts of interest in this work. EDAT- 2023/10/27 06:42 MHDA- 2023/10/27 06:43 PMCR- 2023/10/21 CRDT- 2023/10/27 04:27 PHST- 2023/07/12 00:00 [received] PHST- 2023/09/21 00:00 [accepted] PHST- 2023/10/27 06:43 [medline] PHST- 2023/10/27 06:42 [pubmed] PHST- 2023/10/27 04:27 [entrez] PHST- 2023/10/21 00:00 [pmc-release] AID - 426308 [pii] AID - 10.2147/JHC.S426308 [doi] PST - epublish SO - J Hepatocell Carcinoma. 2023 Oct 21;10:1861-1871. doi: 10.2147/JHC.S426308. eCollection 2023.