The British journal of radiology · 2026
Efficacy and safety of transarterial chemoembolization and radiofrequency ablation plus tyrosine kinase inhibitors with or without programmed cell death protein-1 inhibitors for unresectable hepatocellular carcinoma.
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Chen Yue, Jia Luyao, Sun Yibo, Wang Zhenshun, Li Yu, Wang Jukun, Zhang Chao, Bian Chunjing, Lin Dongdong, Luo Tao
Аннотация
OBJECTIVES: The purpose of this study was to compare the efficacy and safety of transarterial chemoembolization combined with radiofrequency ablation (TACE-RFA) plus tyrosine kinase inhibitors (TKI) with or without programmed cell death protein-1 (PD-1) inhibitors in the treatment of unresectable hepatocellular carcinoma (uHCC).
METHODS: From January 2020 to October 2024, 87 patients with uHCC who received TACE-RFA plus TKI with or without PD-1 inhibitors in our center were retrospectively analyzed, and divided into TACE-RFA + TKI (TRK) group and TACE-RFA + TKI + PD-1 (TRKP) group. Kaplan-Meier method and log-rank test were used to analyze overall survival (OS) and progression-free survival (PFS) of the 2 groups. Adverse events (AEs) between the 2 groups were evaluated according to Common Adverse Event Evaluation Criteria (CTCAEs) Version 5.0.
RESULTS: The patients in the TRKP group had longer median OS (mOS) (24 [95% confidence interval (CI): 17.7-30.3] vs. 18 [95% CI: 15.1-20.9] months, P = .04) and median PFS (mPFS) (15[95% CI: 13.4-16.6] vs. 12 [95% CI: 10.8-13.2] months, P = .01) than that in the TRK group. The objective response rate (ORR) (44.19% vs 36.36%, P = .03) and disease control rate (DCR) (86.05% vs. 70.45%, P = .08) in the TRKP group were better than those in the TRK group. There was no significant difference in the frequency and severity of AEs between the 2 groups.
CONCLUSIONS: The treatment of TACE-RFA + TKI + PD-1 inhibitors is effective and safe for uHCC.
ADVANCES IN KNOWLEDGE: This study advances knowledge by showing that the TACE-RFA + TKI + PD-1 (TRKP) regimen is more effective than TACE-RFA + TKI (TRK) in improving median overall survival, median progression-free survival, and objective response rate for unresectable hepatocellular carcinoma (uHCC) with controllable adverse events, and identifies TRKP as an independent favorable prognostic factor, while AFP ≥400 ng/mL and BCLC stage C as adverse prognostic factors for uHCC.
METHODS: From January 2020 to October 2024, 87 patients with uHCC who received TACE-RFA plus TKI with or without PD-1 inhibitors in our center were retrospectively analyzed, and divided into TACE-RFA + TKI (TRK) group and TACE-RFA + TKI + PD-1 (TRKP) group. Kaplan-Meier method and log-rank test were used to analyze overall survival (OS) and progression-free survival (PFS) of the 2 groups. Adverse events (AEs) between the 2 groups were evaluated according to Common Adverse Event Evaluation Criteria (CTCAEs) Version 5.0.
RESULTS: The patients in the TRKP group had longer median OS (mOS) (24 [95% confidence interval (CI): 17.7-30.3] vs. 18 [95% CI: 15.1-20.9] months, P = .04) and median PFS (mPFS) (15[95% CI: 13.4-16.6] vs. 12 [95% CI: 10.8-13.2] months, P = .01) than that in the TRK group. The objective response rate (ORR) (44.19% vs 36.36%, P = .03) and disease control rate (DCR) (86.05% vs. 70.45%, P = .08) in the TRKP group were better than those in the TRK group. There was no significant difference in the frequency and severity of AEs between the 2 groups.
CONCLUSIONS: The treatment of TACE-RFA + TKI + PD-1 inhibitors is effective and safe for uHCC.
ADVANCES IN KNOWLEDGE: This study advances knowledge by showing that the TACE-RFA + TKI + PD-1 (TRKP) regimen is more effective than TACE-RFA + TKI (TRK) in improving median overall survival, median progression-free survival, and objective response rate for unresectable hepatocellular carcinoma (uHCC) with controllable adverse events, and identifies TRKP as an independent favorable prognostic factor, while AFP ≥400 ng/mL and BCLC stage C as adverse prognostic factors for uHCC.