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Updated: Jan 20, 2026

Y-90 Radioembolization and PD-1 Inhibitor as Neoadjuvant Treatment in Hepatocellular Carcinoma
Published on: May 24, 2024
Prognostic Usefulness of Clinical Complete Response after PD-1 Inhibitor-Based Combination Therapy for Unresectable
Liang Ma1, Da-Long Yang1, Teng-Meng Zhong2
1Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, China.
Clinical complete response (cCR) after PD-1 inhibitor combination therapy indicates excellent survival for unresectable hepatocellular carcinoma (HCC) patients. Identifying predictors of cCR aids in managing HCC and improving patient prognosis.
Area of Science:
- Hepatobiliary Surgery
- Medical Oncology
- Immunotherapy
Background:
- Outcomes for unresectable hepatocellular carcinoma (HCC) patients achieving clinical complete response (cCR) with PD-1 inhibitor combination therapy are not well-defined.
- This study investigates cCR as a prognostic indicator and identifies predictors for cCR and pathological complete response in HCC management.
Purpose of the Study:
- To evaluate the prognostic value of clinical complete response (cCR) in unresectable hepatocellular carcinoma (HCC) patients treated with PD-1 inhibitor-based combination therapy.
- To identify predictors of cCR and pathological complete response to guide HCC patient management.
Main Methods:
- Retrospective analysis of 1,266 unresectable HCC patients receiving PD-1 inhibitor combination therapy and interventional therapy across 23 centers (2019-2023).
- Comparison of survival between patients with and without cCR post-therapy, including subgroup analyses for pathological response and hepatectomy.
- Propensity score matching and multivariable analysis to identify predictors of cCR.
Main Results:
- 15.8% of patients achieved cCR; 28.4% underwent curative hepatectomy.
- Patients achieving cCR demonstrated significantly higher 3-year overall survival (82.4% vs. 35.9%) and progression-free survival (63.4% vs. 26.4%) compared to non-cCR patients.
- Independent predictors of cCR included AFP <400 ng/mL, single tumor, no macrovascular invasion, no extrahepatic metastasis, and combination with anti-angiogenic agents. cCR strongly correlated with pathological complete response.
Conclusions:
- Clinical complete response (cCR) following PD-1 inhibitor-based combination therapy is linked to superior survival outcomes in unresectable HCC.
- cCR and its predictive clinical characteristics can serve as valuable tools for assessing prognosis in HCC patients undergoing combination therapy.
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