Efficacy of TACE Combined with Lenvatinib Plus Sintilimab for Hepatocellular Carcinoma with Tumor Thrombus in the Inferior Vena Cava and/or Right Atrium

Shangkun Ning,1,* Xinge Li,2,* Xiangyu Ma,1 Jibing Liu,1 Xu Chang3 1Department of Interventional Therapy I, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, People’s Republic of China; 2Department of...

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Main Authors: Ning S, Li X, Ma X, Liu J, Chang X
Format: Article
Language:English
Published: Dove Medical Press 2023-09-01
Series:Journal of Hepatocellular Carcinoma
Subjects:
Online Access:https://www.dovepress.com/efficacy-of-tace-combined-with-lenvatinib-plus-sintilimab-for-hepatoce-peer-reviewed-fulltext-article-JHC
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author Ning S
Li X
Ma X
Liu J
Chang X
author_facet Ning S
Li X
Ma X
Liu J
Chang X
author_sort Ning S
collection DOAJ
description Shangkun Ning,1,* Xinge Li,2,* Xiangyu Ma,1 Jibing Liu,1 Xu Chang3 1Department of Interventional Therapy I, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, People’s Republic of China; 2Department of Oncology, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China; 3Department of Interventional Therapy II, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xu Chang, Department of Interventional Therapy II, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, 250117, People’s Republic of China, Tel +86-531-18769785023, Email cx18769785023@163.comPurpose: To validate the safety and effectiveness of transarterial chemoembolization (TACE) combination with lenvatinib and sintilimab in treating hepatocellular carcinoma (HCC) patients with inferior vena cava (IVC) and/or right atrium (RA) tumor thrombosis (TT).Methods: This study retrospectively analyzed HCC patients with IVC and/or RA TT treated with TACE combined with lenvatinib plus sintilimab. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR) were calculated to evaluate the anti-tumor efficacy. Treatment-related adverse events (TRAEs) were analyzed to assess the safety profiles.Results: A total of 58 patients were screened for eligibility between March 2019 and May 2022. At the time of data collection, 48.2% of patients were still receiving treatment. The median follow-up was 23.5 months. The ORR was 48.3%, the DCR was 91.4%, the median OS was 17.3 months, and the median PFS was 13.0 months. The ORR for IVC/RA TT was 62.1%, DCR was 94.9%, and the median PFS was 14.3 months. 56.9% of patients experienced ≥ grade 3 TRAEs, such as hypertension (10.3%) and elevated liver enzymes (13.8%). No new safety signals were identified. Participants with low levels of serum PCT value had satisfactory prognoses.Conclusion: TACE combination with lenvatinib plus sintilimab is effective in treating HCC with IVC and/or RA TT. The toxicities were manageable, with no unexpected safety signals. The baseline levels of serum PCT might be the predictive biomarkers for the triple combination therapy.Keywords: hepatocellular carcinoma, inferior vena cava tumor thrombus, transarterial chemoembolization, lenvatinib, sintilimab
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spelling doaj.art-044137f9ce3e4b0c823971760c6b3ef42023-09-14T19:09:03ZengDove Medical PressJournal of Hepatocellular Carcinoma2253-59692023-09-01Volume 101511152586652Efficacy of TACE Combined with Lenvatinib Plus Sintilimab for Hepatocellular Carcinoma with Tumor Thrombus in the Inferior Vena Cava and/or Right AtriumNing SLi XMa XLiu JChang XShangkun Ning,1,* Xinge Li,2,* Xiangyu Ma,1 Jibing Liu,1 Xu Chang3 1Department of Interventional Therapy I, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, People’s Republic of China; 2Department of Oncology, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China; 3Department of Interventional Therapy II, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xu Chang, Department of Interventional Therapy II, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, 250117, People’s Republic of China, Tel +86-531-18769785023, Email cx18769785023@163.comPurpose: To validate the safety and effectiveness of transarterial chemoembolization (TACE) combination with lenvatinib and sintilimab in treating hepatocellular carcinoma (HCC) patients with inferior vena cava (IVC) and/or right atrium (RA) tumor thrombosis (TT).Methods: This study retrospectively analyzed HCC patients with IVC and/or RA TT treated with TACE combined with lenvatinib plus sintilimab. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR) were calculated to evaluate the anti-tumor efficacy. Treatment-related adverse events (TRAEs) were analyzed to assess the safety profiles.Results: A total of 58 patients were screened for eligibility between March 2019 and May 2022. At the time of data collection, 48.2% of patients were still receiving treatment. The median follow-up was 23.5 months. The ORR was 48.3%, the DCR was 91.4%, the median OS was 17.3 months, and the median PFS was 13.0 months. The ORR for IVC/RA TT was 62.1%, DCR was 94.9%, and the median PFS was 14.3 months. 56.9% of patients experienced ≥ grade 3 TRAEs, such as hypertension (10.3%) and elevated liver enzymes (13.8%). No new safety signals were identified. Participants with low levels of serum PCT value had satisfactory prognoses.Conclusion: TACE combination with lenvatinib plus sintilimab is effective in treating HCC with IVC and/or RA TT. The toxicities were manageable, with no unexpected safety signals. The baseline levels of serum PCT might be the predictive biomarkers for the triple combination therapy.Keywords: hepatocellular carcinoma, inferior vena cava tumor thrombus, transarterial chemoembolization, lenvatinib, sintilimabhttps://www.dovepress.com/efficacy-of-tace-combined-with-lenvatinib-plus-sintilimab-for-hepatoce-peer-reviewed-fulltext-article-JHChepatocellular carcinomainferior vena cava tumor thrombustransarterial chemoembolizationlenvatinibsintilimab
spellingShingle Ning S
Li X
Ma X
Liu J
Chang X
Efficacy of TACE Combined with Lenvatinib Plus Sintilimab for Hepatocellular Carcinoma with Tumor Thrombus in the Inferior Vena Cava and/or Right Atrium
Journal of Hepatocellular Carcinoma
hepatocellular carcinoma
inferior vena cava tumor thrombus
transarterial chemoembolization
lenvatinib
sintilimab
title Efficacy of TACE Combined with Lenvatinib Plus Sintilimab for Hepatocellular Carcinoma with Tumor Thrombus in the Inferior Vena Cava and/or Right Atrium
title_full Efficacy of TACE Combined with Lenvatinib Plus Sintilimab for Hepatocellular Carcinoma with Tumor Thrombus in the Inferior Vena Cava and/or Right Atrium
title_fullStr Efficacy of TACE Combined with Lenvatinib Plus Sintilimab for Hepatocellular Carcinoma with Tumor Thrombus in the Inferior Vena Cava and/or Right Atrium
title_full_unstemmed Efficacy of TACE Combined with Lenvatinib Plus Sintilimab for Hepatocellular Carcinoma with Tumor Thrombus in the Inferior Vena Cava and/or Right Atrium
title_short Efficacy of TACE Combined with Lenvatinib Plus Sintilimab for Hepatocellular Carcinoma with Tumor Thrombus in the Inferior Vena Cava and/or Right Atrium
title_sort efficacy of tace combined with lenvatinib plus sintilimab for hepatocellular carcinoma with tumor thrombus in the inferior vena cava and or right atrium
topic hepatocellular carcinoma
inferior vena cava tumor thrombus
transarterial chemoembolization
lenvatinib
sintilimab
url https://www.dovepress.com/efficacy-of-tace-combined-with-lenvatinib-plus-sintilimab-for-hepatoce-peer-reviewed-fulltext-article-JHC
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