AUTHOR=Zhang Zi-Han , Hou Si-Nan , Yu Jia-Ze , Zhang Wen , Ma Jing-Qin , Yang Min-Jie , Liu Qing-Xin , Liu Ling-Xiao , Luo Jian-Jun , Qu Xu-Dong , Yan Zhi-Ping 

TITLE=Combined iodine-125 seed strand, portal vein stent, transarterial chemoembolization, lenvatinib and anti-PD-1 antibodies therapy for hepatocellular carcinoma and Vp4 portal vein tumor thrombus: A propensity-score analysis

JOURNAL=Frontiers in Oncology

VOLUME=12

YEAR=2023

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.1086095

DOI=10.3389/fonc.2022.1086095

ISSN=2234-943X

ABSTRACT=<sec><title>Objective</title><p>To evaluate the safety and efficacy of interventional therapy (iodine-125[<sup>125</sup>I] seed strand and portal vein stent [PVS] implantation plus transarterial chemoembolization [TACE]) combined with systemic therapy (lenvatinib plus anti-PD-1 antibody) as first-line treatment for hepatocellular carcinoma (HCC) patients with Vp4 portal vein tumor thrombus (PVTT).</p></sec><sec><title>Patients and methods</title><p>From December 2018 to October 2021, 87 HCC patients with Vp4 PVTT were included in this single-center retrospective study. Forty-seven patients underwent interventional therapy combined with lenvatinib and anti-PD-1 antibody (group A), while 40 cases underwent interventional therapy combined with lenvatinib only (group B). Overall response rate (ORR), stent occlusion rates (SOR), median overall survival (OS), median progression-free survival (PFS) and median stent patency time (SPT) were compared between the 2 groups.</p></sec><sec><title>Results</title><p>The mean intended dose (r = 10 mm; z = 0; 240 days) was 64.9 ± 1.0 Gy and 64.5 ± 1.1 Gy in group A and B, respectively (<italic>p</italic> = 0.133). ORR and SOR were significantly different between group A and B (ORR, 55.3% vs 17.5%, <italic>p</italic> &lt; 0.001; SOR, 12.8% vs 35.0%, <italic>p</italic> = 0.014). In the propensity-score matching (PSM) cohort, the median OS, median PFS and median SPT were significantly longer in group A compared with group B (32 PSM pairs; OS, 17.7 ± 1.7 vs 12.0 ± 0.8 months, <italic>p</italic> = 0.010; PFS, 17.0 ± 4.3 vs 8.0 ± 0.7 months, <italic>p</italic> &lt; 0.001; SPT, not-reached vs 12.5 ± 1.1 months, <italic>p</italic> = 0.028).</p></sec><sec><title>Conclusion</title><p>This interventional therapy combined with lenvatinib and anti-PD-1 antibody is safe and effective for HCC patients with Vp4 PVTT.</p></sec>