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ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gastrointestinal Cancers: Hepato Pancreatic Biliary Cancers
Volume 15 - 2025 |
doi: 10.3389/fonc.2025.1554711
This article is part of the Research Topic Liver Cancer Awareness Month 2024: Current Progress and Future Prospects on Advances in Primary Liver Cancer Investigation and Treatment View all 9 articles
Enhanced Efficacy of Immune Checkpoint Inhibitors Combined Locoregional Therapy and Tyrosine Kinase Inhibitors in the Treatment of Unresectable Hepatocellular Carcinoma: A Single -Center Retrospective Study
Provisionally accepted- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
Background: Unresectable hepatocellular carcinoma (HCC) presents significant treatment challenges. While locoregional therapies (LT) and tyrosine kinase inhibitors (TKI) offer some benefits, prognosis remains poor. Immune checkpoint inhibitors (ICI) have shown promise in other oncological settings, suggesting potential benefits in HCC treatment regimens. Methods This retrospective study analyzed 232 patients diagnosed with unresectable HCC at West China Hospital from January 2019 to December 2023. Patients were categorized into two treatment groups: LT+TKI and LT+TKI+ICI. All patients underwent standardized locoregional treatments and first-line TKIs, with the latter group also receiving ICIs. The primary outcomes measured were overall survival (OS) and progression-free survival (PFS). Survival analysis utilized Kaplan-Meier estimates and Cox regression models.The LT+TKI+ICI group demonstrated significantly improved survival outcomes compared to the LT+TKI group. Median OS was 28 ± 3.9 months in the LT+TKI+ICI group versus 21 ± 3.0 months in the LT+TKI group, with corresponding 6-, 12-, and 24-month OS rates of 96.8%, 79.3%, and 59.4% versus 85.8%, 71.5%, and 44.1%, respectively (HR, 0.64; 95% CI, 0.449-0.913; P = 0.014). Median PFS also favored the LT+TKI+ICI group (11 ± 1.1 months vs. 7 ± 0.76 months; HR, 0.60; 95% CI, 0.452-0.805; P<0.001). Multivariable analysis identified LT+TKI, vascular invasion, and metastasis as independent risk factors for poorer survival outcomes.Adding ICI to LT and TKI significantly extends both OS and PFS in patients with unresectable HCC. These findings suggest that integrating ICI into treatment protocols could be beneficial in managing unresectable HCC, particularly for patients with vascular invasion.
Keywords: Unresectable hepatocellular carcinoma, Locoregional therapy, tyrosine kinase inhibitor, Immune checkpoint inhibitor, System therapy
Received: 02 Jan 2025; Accepted: 04 Feb 2025.
Copyright: © 2025 Bu, Li, Hu, Lan, Huang, Wang, Li, Zhou and Zeng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jin Zhou, West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
Yong Zeng, West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
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