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Updated: Feb 19, 2026

Y-90 Radioembolization and PD-1 Inhibitor as Neoadjuvant Treatment in Hepatocellular Carcinoma
Published on: May 24, 2024
TACE and tyrosine kinase inhibitors with or without PD-1 inhibitors as first-line therapy for intermediate-advanced
Xue-Gang Yang1, Li-Wei Deng1, Yong Zhao2
1Department of Interventional Therapy, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China.
Background And Aims:
This study aimed to evaluate the efficacy and safety of combining transarterial chemoembolization (TACE) and tyrosine kinase inhibitors (TKIs), with or without programmed death-1 (PD-1) inhibitors (ICI), as first-line therapy for intermediate-advanced hepatocellular carcinoma (HCC) in a real-world setting.
Methods:
This multicentre retrospective cohort study enrolled patients with intermediate-advanced HCC who received either TACE combined with TKIs and PD-1 inhibitors (TACE-TKI-ICI) or TACE plus TKIs (TACE-TKI) from January 2019 to December 2023. The outcomes included progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and safety. Propensity score matching (PSM) was used to reduce bias.
Results:
A total of 514 patients with intermediate-advanced HCC were analyzed, 263 patients in the TACE-TKI-ICI group and 251 patients in the TACE-TKI group. After PSM (1:1), 241 patients were included in each group. The TACE-TKI-ICI group had significantly longer median PFS (13.8 vs. 10.8 months; hazard ratio [HR] = 0.73; 95% confidence interval [CI], 0.58-0.91; p = 0.005) and OS (22.6 vs. 16.7 months; HR = 0.71; 95% CI, 0.55-0.91; p = 0.006) than the TACE-TKI group. The ORR was also better (58.9% vs. 41.5%, p < 0.001) in the TACE-TKI-ICI group. The incidence of grade 3/4 adverse events was 10.8% in the TACE-TKI-ICI group and 8.3% in the TACE-TKI group.
Conclusion:
Adding PD-1 inhibitors to TACE and TKIs as first-line therapy for intermediate-advanced HCC can improve PFS, OS, and ORR, while being well tolerated.
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