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Updated: Sep 16, 2025

Transradial Access Chemoembolization for Hepatocellular Carcinoma Patients
Published on: September 20, 2020
Updated Network Meta-Analysis of First-Line Systemic Treatments for Advanced HCC: Consistent Role of TACE.
Ye Rim Kim1, Euichang Kim1, Ha Il Kim2
1Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Transarterial chemoembolization (TACE) combined with lenvatinib offers the best survival outcomes for advanced hepatocellular carcinoma (HCC). Immunotherapy combinations also show promise, but TACE + lenvatinib
Area of Science:
- Hepatology and Oncology
- Clinical Trials and Network Meta-Analysis
Background:
- Advanced hepatocellular carcinoma (HCC) requires effective first-line treatments.
- Evaluating novel interventional and targeted therapies is crucial.
Purpose of the Study:
- To identify the optimal first-line treatment for advanced HCC.
- To compare interventional and targeted therapies using network meta-analysis.
Main Methods:
- Network meta-analysis of 16 phase 2/3 randomized controlled trials (2018-2024).
- Involved 9,482 patients with metastatic or unresectable HCC.
- Evaluated 11 systemic agents and 5 interventional combinations against sorafenib/lenvatinib, focusing on overall survival (OS) and progression-free survival (PFS).
Main Results:
- Transarterial chemoembolization (TACE) + lenvatinib demonstrated the greatest OS improvement (HR 0.41).
- Several immunotherapy combinations (sintilimab + IBI305, camrelizumab + rivoceranib, atezolizumab + bevacizumab) also showed significant OS and PFS benefits.
- TACE + lenvatinib, sintilimab + IBI305, and atezolizumab + bevacizumab were effective across specific patient subsets (portal invasion, extrahepatic metastasis, hepatitis B).
Conclusions:
- TACE + lenvatinib is the leading first-line treatment for advanced HCC based on survival outcomes.
- Immunotherapy-based combinations represent viable alternatives.
- The efficacy of TACE + lenvatinib may be influenced by regional hepatitis B virus prevalence.
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