Frontiers in oncology · 2026
Efficacy and safety of combining TACE with atezolizumab/bevacizumab versus TACE alone: a retrospective propensity score-matched cohort study in HBV-related hepatocellular carcinoma.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Feng Jie, Lin Guocheng, Wang Yeyan
Аннотация
BACKGROUND: Transarterial chemoembolization (TACE) is an established treatment for intermediate to advanced hepatocellular carcinoma (HCC) in China, where chronic hepatitis B virus (HBV) infection constitutes the primary etiology. Although the use of TACE combined with atezolizumab/bevacizumab (TACE+TA) is increasing, robust evidence regarding its efficacy and safety-including the risk of HBV reactivation-remains limited in this etiologically distinct population.
METHODS: This retrospective analysis included 246 patients with HBV-related HCC treated between 2020 and 2024. Patients were stratified according to the treatment received: TACE monotherapy (n = 113) or TACE+TA (n = 133). The primary endpoints were overall survival (OS) and progression-free survival (PFS). Tumor response was assessed using the modified Response Evaluation Criteria in Solid Tumors (mRECIST). To minimize selection bias, a 1:1 propensity score matching (PSM) analysis was performed.
RESULTS: After matching, patients receiving TACE+TA achieved superior outcomes compared with TACE monotherapy, with prolonged median OS (19 vs. 13 months; P < 0.001) and extended median PFS (8 vs. 6 months; P = 0.004). In the unmatched cohort, the objective response rate was also higher in the combination group (48.1% vs. 30.0%; P = 0.004). Independent risk factors for worse OS included elevated baseline HBV-DNA load, advanced BCLC stage, and receipt of monotherapy. Notably, the combination therapy group experienced a higher incidence of adverse events, particularly HBV reactivation (8.3% vs. 1.8%; P = 0.023), immune-mediated hepatitis, pneumonitis, and thrombocytopenia.
CONCLUSIONS: In patients with HBV-related HCC, TACE+TA confers a significant survival advantage over TACE monotherapy, albeit with an increased risk of HBV reactivation and immune-related adverse events. This finding underscores the need for rigorous antiviral prophylaxis and close monitoring in clinical practice.
METHODS: This retrospective analysis included 246 patients with HBV-related HCC treated between 2020 and 2024. Patients were stratified according to the treatment received: TACE monotherapy (n = 113) or TACE+TA (n = 133). The primary endpoints were overall survival (OS) and progression-free survival (PFS). Tumor response was assessed using the modified Response Evaluation Criteria in Solid Tumors (mRECIST). To minimize selection bias, a 1:1 propensity score matching (PSM) analysis was performed.
RESULTS: After matching, patients receiving TACE+TA achieved superior outcomes compared with TACE monotherapy, with prolonged median OS (19 vs. 13 months; P < 0.001) and extended median PFS (8 vs. 6 months; P = 0.004). In the unmatched cohort, the objective response rate was also higher in the combination group (48.1% vs. 30.0%; P = 0.004). Independent risk factors for worse OS included elevated baseline HBV-DNA load, advanced BCLC stage, and receipt of monotherapy. Notably, the combination therapy group experienced a higher incidence of adverse events, particularly HBV reactivation (8.3% vs. 1.8%; P = 0.023), immune-mediated hepatitis, pneumonitis, and thrombocytopenia.
CONCLUSIONS: In patients with HBV-related HCC, TACE+TA confers a significant survival advantage over TACE monotherapy, albeit with an increased risk of HBV reactivation and immune-related adverse events. This finding underscores the need for rigorous antiviral prophylaxis and close monitoring in clinical practice.