Hepatocellular Carcinoma with Radiological Progression: Lenvatinib Plus PD-1 Inhibitor Combined with Microwave Ablation and Synchronous Transarterial Chemoembolization
Qin Shi,1– 3,* Peng Huang,2,4,* Zihan Zhang,1– 3,* Wen Zhang,1– 3 Lingxiao Liu,1– 3 Zhiping Yan1– 3 1Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People’s Republic of China; 2Shanghai Institution of Medical Imaging, Fudan Uni...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2023-10-01
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| Series: | Journal of Hepatocellular Carcinoma |
| Subjects: | |
| Online Access: | https://www.dovepress.com/hepatocellular-carcinoma-with-radiological-progression-lenvatinib-plus-peer-reviewed-fulltext-article-JHC |
| _version_ | 1827787129254576128 |
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| author | Shi Q Huang P Zhang Z Zhang W Liu L Yan Z |
| author_facet | Shi Q Huang P Zhang Z Zhang W Liu L Yan Z |
| author_sort | Shi Q |
| collection | DOAJ |
| description | Qin Shi,1– 3,* Peng Huang,2,4,* Zihan Zhang,1– 3,* Wen Zhang,1– 3 Lingxiao Liu,1– 3 Zhiping Yan1– 3 1Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People’s Republic of China; 2Shanghai Institution of Medical Imaging, Fudan University, Shanghai, 200032, People’s Republic of China; 3National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, People’s Republic of China; 4Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People’s Republic of China*These authors contributed equally to this workCorrespondence: Lingxiao Liu; Zhiping Yan, Email liu.lingxiao119@aliyun.com; zhipingyan@fudan.edu.cnPurpose: 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.Keywords: hepatocellular carcinoma, radiological progression, microwave ablation, lenvatinib, PD-1 inhibitor |
| first_indexed | 2024-03-11T16:45:10Z |
| format | Article |
| id | doaj.art-4afee9afe8014a41ab59348fca27cac4 |
| institution | Directory Open Access Journal |
| issn | 2253-5969 |
| language | English |
| last_indexed | 2024-03-11T16:45:10Z |
| publishDate | 2023-10-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Hepatocellular Carcinoma |
| spelling | doaj.art-4afee9afe8014a41ab59348fca27cac42023-10-22T19:32:43ZengDove Medical PressJournal of Hepatocellular Carcinoma2253-59692023-10-01Volume 101861187187538Hepatocellular Carcinoma with Radiological Progression: Lenvatinib Plus PD-1 Inhibitor Combined with Microwave Ablation and Synchronous Transarterial ChemoembolizationShi QHuang PZhang ZZhang WLiu LYan ZQin Shi,1– 3,* Peng Huang,2,4,* Zihan Zhang,1– 3,* Wen Zhang,1– 3 Lingxiao Liu,1– 3 Zhiping Yan1– 3 1Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People’s Republic of China; 2Shanghai Institution of Medical Imaging, Fudan University, Shanghai, 200032, People’s Republic of China; 3National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, People’s Republic of China; 4Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People’s Republic of China*These authors contributed equally to this workCorrespondence: Lingxiao Liu; Zhiping Yan, Email liu.lingxiao119@aliyun.com; zhipingyan@fudan.edu.cnPurpose: 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.Keywords: hepatocellular carcinoma, radiological progression, microwave ablation, lenvatinib, PD-1 inhibitorhttps://www.dovepress.com/hepatocellular-carcinoma-with-radiological-progression-lenvatinib-plus-peer-reviewed-fulltext-article-JHChepatocellular carcinomaradiological progressionmicrowave ablationlenvatinibpd-1 inhibitor |
| spellingShingle | Shi Q Huang P Zhang Z Zhang W Liu L Yan Z Hepatocellular Carcinoma with Radiological Progression: Lenvatinib Plus PD-1 Inhibitor Combined with Microwave Ablation and Synchronous Transarterial Chemoembolization Journal of Hepatocellular Carcinoma hepatocellular carcinoma radiological progression microwave ablation lenvatinib pd-1 inhibitor |
| title | Hepatocellular Carcinoma with Radiological Progression: Lenvatinib Plus PD-1 Inhibitor Combined with Microwave Ablation and Synchronous Transarterial Chemoembolization |
| title_full | Hepatocellular Carcinoma with Radiological Progression: Lenvatinib Plus PD-1 Inhibitor Combined with Microwave Ablation and Synchronous Transarterial Chemoembolization |
| title_fullStr | Hepatocellular Carcinoma with Radiological Progression: Lenvatinib Plus PD-1 Inhibitor Combined with Microwave Ablation and Synchronous Transarterial Chemoembolization |
| title_full_unstemmed | Hepatocellular Carcinoma with Radiological Progression: Lenvatinib Plus PD-1 Inhibitor Combined with Microwave Ablation and Synchronous Transarterial Chemoembolization |
| title_short | Hepatocellular Carcinoma with Radiological Progression: Lenvatinib Plus PD-1 Inhibitor Combined with Microwave Ablation and Synchronous Transarterial Chemoembolization |
| title_sort | hepatocellular carcinoma with radiological progression lenvatinib plus pd 1 inhibitor combined with microwave ablation and synchronous transarterial chemoembolization |
| topic | hepatocellular carcinoma radiological progression microwave ablation lenvatinib pd-1 inhibitor |
| url | https://www.dovepress.com/hepatocellular-carcinoma-with-radiological-progression-lenvatinib-plus-peer-reviewed-fulltext-article-JHC |
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