Transcatheter arterial chemoembolization plus Sorafenib versus transcatheter arterial chemoembolization plus Lenvatinib for intermediate hepatocellular carcinoma

• Published in: Scientific reports Vol. 14; no. 1; pp. 25616 - 17
• Main Authors: Wang, Moxuan, Cheng, Jiamin, Qian, Niansong
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 27-10-2024; Nature Publishing Group; Nature Portfolio
• Subjects: 631/67; 692/308; 692/4028; Aged; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - therapeutic use; Carcinoma, Hepatocellular - drug therapy; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - therapy; Chemoembolization; Chemoembolization, Therapeutic - adverse effects; Chemoembolization, Therapeutic - methods; Cirrhosis; Combination therapy; Combined Modality Therapy; Disease control; Doppler effect; Female; Hepatocellular carcinoma; Humanities and Social Sciences; Humans; Hypertension; Inflammation; Intermediate-stage hepatocellular carcinoma; Lenvatinib; Liver cancer; Liver Neoplasms - drug therapy; Liver Neoplasms - mortality; Liver Neoplasms - pathology; Liver Neoplasms - therapy; Male; Middle Aged; multidisciplinary; Phenylurea Compounds - administration & dosage; Phenylurea Compounds - adverse effects; Phenylurea Compounds - therapeutic use; Portal hypertension; Portal vein; Quinolines - administration & dosage; Quinolines - adverse effects; Quinolines - therapeutic use; Retrospective Studies; Science; Science (multidisciplinary); Side effects; Sorafenib; Sorafenib - administration & dosage; Sorafenib - therapeutic use; Transcatheter arterial chemoembolization; Treatment Outcome; Lenvatinib; Intermediate-stage hepatocellular carcinoma; Combination therapy; Transcatheter arterial chemoembolization; Sorafenib; Portal hypertension
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-74801-x

Background: Recent studies have highlighted that TACE in conjunction with Lenvatinib (TACE-L) offers a promising adjunct therapy for advanced HCC patients, outperforming TACE plus Sorafenib (TACE-S). However, there has been a lack of research comparing these two regimens for intermediate HCC. Aims: This study aims to address the research gap by evaluating the efficacy of TACE-L versus TACE-S in intermediate HCC patients. Methods: A retrospective analysis was conducted on a cohort of consecutive intermediate HCC patients who received either TACE-L or TACE-S from November 2018 to December 2022. Portal vein width was assessed using abdominal NMRI or Doppler ultrasonography, and inflammatory markers were derived from routine blood counts. The primary outcomes of interest were overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and adverse drug reactions (ADRs). Results: The study included 117 patients, with 56 in the TACE-S group and 61 in the TACE-L group. The TACE-S group demonstrated superior OS (HR = 1.704, 95% CI: 1.012–2.870,
p
 = 0.045) compared to the TACE-L group. No significant difference was observed in PFS (HR:1.512, 95% CI: 0.988–2.313,
p
 = 0.057) between the two groups. Subgroup analyses revealed that male patients, those with cirrhosis, and those with more than four tumors had better OS and PFS in the TACE-S group than in the TACE-L group. Inflammatory markers were comparable between the groups. The TACE-S group experienced a higher incidence of palmar-plantar erythrodysesthesia syndrome (PPE) (14/56 [25%] vs. 5/61 [8.1%],
p
 = 0.014) but a lower incidence of hypertension (3/56 [5.3%] vs. 11/61 [18%],
p
 = 0.035) compared to the TACE-L group. Conclusions: In patients with intermediate HCC, TACE-S was found to be more effective in terms of OS than TACE-L. No significant disparity was noted in PFS between the two treatment groups.