Transarterial chemoembolization combined with lenvatinib versus transarterial chemoembolization combined with...

Area of Science:

• Hepatobiliary Oncology
• Interventional Radiology
• Pharmacological Therapy

Background:

• Hepatocellular carcinoma (HCC) is a primary liver malignancy with limited treatment options for unresectable cases.
• Transarterial chemoembolization (TACE) is a standard locoregional therapy for HCC.
• Tyrosine kinase inhibitors (TKIs) targeting vascular endothelial growth factor (VEGF) can enhance TACE efficacy by inhibiting tumor angiogenesis.

Purpose of the Study:

• To compare the clinical outcomes of TACE combined with lenvatinib (TACE-lenvatinib) versus TACE combined with sorafenib (TACE-sorafenib) in patients with unresectable HCC.
• To evaluate the efficacy and safety profiles of these two combination therapies.

Main Methods:

• Retrospective review of clinical data for 112 patients with unresectable HCC treated between January 2018 and April 2021.
• Comparison of tumor response, progression-free survival (PFS), overall survival (OS), and adverse events (AEs) between the TACE-lenvatinib and TACE-sorafenib groups.

Main Results:

• TACE-lenvatinib showed a higher disease control rate (81.1% vs. 61.0%, p=0.020) compared to TACE-sorafenib.
• Median PFS was significantly longer with TACE-lenvatinib (10.7 months) than TACE-sorafenib (6.0 months, p=0.002).
• Median OS was also significantly improved in the TACE-lenvatinib group (30.5 months vs. 20.5 months, p=0.018).
• Objective response rates were comparable (54.7% vs. 44.1%, p=0.260).
• Treatment-related and severe adverse events were similar between both groups.

Conclusions:

• TACE-lenvatinib offers superior disease control, PFS, and OS compared to TACE-sorafenib for unresectable HCC.
• Lenvatinib may provide a more effective treatment option, particularly for patients with Barcelona Clinic Liver Cancer B stage or TACE-refractory disease.