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ORIGINAL RESEARCH article

Front. Pharmacol.
Sec. Gastrointestinal and Hepatic Pharmacology
Volume 15 - 2024 | doi: 10.3389/fphar.2024.1499269
This article is part of the Research Topic Hepatocellular Carcinoma: From Diagnostic Approaches to Surgical and Systemic Therapies View all 14 articles

Efficiency and safety of HAIC combined with lenvatinib and tislelizumab for advanced hepatocellular carcinoma with high tumor burden: a multicenter propensity score matching analysis

Provisionally accepted
Zhonghua Zhao Zhonghua Zhao 1*Xiongying Jiang Xiongying Jiang 2*Shiping Wen Shiping Wen 3*Yanzhang Hao Yanzhang Hao 1*
  • 1 Binzhou Medical University Hospital, Binzhou, China
  • 2 Sun Yat-sen Memorial Hospital, Guangzhou, Guangdong Province, China
  • 3 Sun Yat-sen University Cancer Center (SYSUCC), Guangzhou, Guangdong Province, China

The final, formatted version of the article will be published soon.

    The present work focused on assessing whether hepatic arterial infusion chemotherapy (HAIC) combined with lenvatinib and tislelizumab was safe and effective on advanced hepatocellular carcinoma (HCC) showing high tumor burden.In the present multicenter retrospective study, treatment-naive advanced HCC patients (BCLC stage C) showing high tumor burden (maximum diameter of intrahepatic lesion beyond 7cm) treated with lenvatinib and tislelizumab with or without HAIC were reviewed for eligibility from June 2020 to June 2023. Baseline differences between groups were mitigated by propensity score matching (PSM). Our primary endpoint and secondary endpoints wereas overall survival (OS); and secondary endpoints included adverse events (AEs), progression-free survival (PFS), disease control rate (DCR) and objective response rate (ORR) according to RECIST 1.1 criteria, respectively.Results: After eligibility reviewed, total 162 patients treated with lenvatinib and tislelizumab were enrolled: 63 patients with HAIC (HTP group), and the remaining 99 patients without HAIC (TP group). After PSM 1:1, 47 cases were evenly divided into each group. Of them, HTP group showed the extended mediansignificant prolonged median OS compared with TP group (16.6 versus 21.0 months; hazard ratio [HR]: 0.26, 95% confidence interval [CI]: 0.35-0.98; P = 0.039), and median PFS of HTP group was extended also prolonged (8.9 versus 11.6 months; HR: 0.55, 95% CI: 0.34-0.87; P = 0.010). Higher DCR and ORR could be observed in HTP relative to TP groups (ORR: 53.2% versus 17.0%, P < 0.001; DCR: 87.2% versus 61.7%, P = 0.004). The severe AEs of (grade 3/4) and all grades were undoubtedly statistically highercomparable in between the HTP groups, while all of these AEs could be controlled, and AEs of grade 5 were not reported. Conclusion: HAIC combined with lenvatinib and tislelizumab is the candidate treatment for advanced HCC patients because of its improved prognosis and acceptable safety.

    Keywords: Hepatocellular Carcinoma, Hepatic arterial infusion chemotherapy, tyrosine kinase inhibitors, Programmed cell death protein-1 inhibitors, Propensity score matching

    Received: 20 Sep 2024; Accepted: 18 Dec 2024.

    Copyright: © 2024 Zhao, Jiang, Wen and Hao. 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:
    Zhonghua Zhao, Binzhou Medical University Hospital, Binzhou, China
    Xiongying Jiang, Sun Yat-sen Memorial Hospital, Guangzhou, 510000, Guangdong Province, China
    Shiping Wen, Sun Yat-sen University Cancer Center (SYSUCC), Guangzhou, 510060, Guangdong Province, China
    Yanzhang Hao, Binzhou Medical University Hospital, Binzhou, China

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