Precision Locoregional Therapy Combined with Immune Checkpoint Blockade for Intermediate-Advanced Hepatocellular...

Area of Science:

• Hepatobiliary Oncology
• Interventional Radiology
• Immunotherapy

Background:

• The combination of transarterial chemoembolization (TACE) and immune checkpoint inhibitors (ICIs) for intermediate-to-advanced hepatocellular carcinoma (HCC) requires further definition.
• This study evaluates the efficacy, tolerability, and prognostic factors of TACE plus ICIs in HCC patients.

Purpose of the Study:

• To assess the value of combining TACE with ICIs for intermediate-to-advanced HCC.
• To identify pretreatment characteristics associated with patient prognosis in this cohort.

Main Methods:

• Retrospective analysis of 248 HCC patients from January 2020 to December 2024.
• Comparison between TACE plus ICIs (n=126) and TACE alone (n=122).
• Radiological response assessed by mRSIST; survival endpoints (PFS, OS) analyzed using Kaplan-Meier and Cox regression.

Main Results:

• TACE plus ICIs showed higher objective response (46.0% vs 24.6%) and disease control rates (77.8% vs 59.8%) compared to TACE alone.
• Median PFS was 10.8 months with combination therapy versus 5.6 months with TACE alone; median OS was 21.6 months versus 14.2 months.
• ECOG status, high AFP, PVTT, extrahepatic disease, and high neutrophil-to-lymphocyte ratio predicted worse PFS/OS. Combination therapy was an independent predictor of better outcomes.

Conclusions:

• Integration of ICIs with TACE offers significant improvements in tumor response and survival for intermediate-to-advanced HCC patients.
• The combined approach demonstrates acceptable safety, with serious immune-mediated toxicity in 15.1% of patients.
• Stratification by patient factors like ECOG, liver function, AFP, metastasis, and inflammation can aid personalized prognosis.