Therapeutic advances in medical oncology · 2026
Impact of TACE combined with targeted and immune therapy on liver function and prognosis in unresectable hepatocellular carcinoma patients: the significance of baseline albumin-bilirubin grade.
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Guo Yiwan, Liu Xiaocui, Sun Bo, Pu Fan, Li Xin, Zheng Chuansheng, Kan Xuefeng, Yang Fan
Аннотация
BACKGROUND: Transarterial chemoembolization combined with tyrosine kinase inhibitors and immune checkpoint inhibitors (TTI) has emerged as a promising strategy for unresectable hepatocellular carcinoma (uHCC); however, its impact on liver function and the prognostic role of baseline albumin-bilirubin (ALBI) grade remain insufficiently defined.
OBJECTIVES: To compare the effects of combined therapy and transarterial chemoembolization (TACE) alone on liver function in uHCC patients, and to evaluate the prognostic value of baseline ALBI grade.
DESIGN: This retrospective study enrolled uHCC patients treated with TTI or TACE alone between January 2018 and December 2023.
METHODS: The primary outcome was the time to progression of baseline ALBI grade, with secondary outcomes including overall survival (OS) and progression-free survival (PFS) of patients. Survival outcomes were analyzed using the Kaplan-Meier method.
RESULTS: A total of 162 patients (TTI group: 68; TACE alone group: 94) were included. The TTI group showed a significantly longer median time to progression of baseline ALBI grade than the TACE alone group (19.0 months vs 11.6 months, p = 0.004). Subgroup analyses revealed similar benefits of the TTI group (11.3 months vs 5.0 months for baseline ALBI grade 1, p = 0.015; 20.0 months vs 14.7 months for baseline ALBI grade 2, p = 0.025). Patients in the TTI group demonstrated superior median OS (42.2 months vs 22.0 months for baseline ALBI grade 1, p = 0.077; 22.6 months vs 13.5 months for baseline ALBI grade 2, p = 0.001) and longer median PFS (11.7 months vs 6.8 months for baseline ALBI grade 1, p = 0.148; 8.4 months vs 4.9 months for baseline ALBI grade 2, p = 0.022) compared to the TACE alone group.
CONCLUSION: TTI therapy preserved liver function for a longer duration and achieved better survival outcomes than TACE alone in uHCC patients, particularly benefiting those with baseline ALBI grade 2.
OBJECTIVES: To compare the effects of combined therapy and transarterial chemoembolization (TACE) alone on liver function in uHCC patients, and to evaluate the prognostic value of baseline ALBI grade.
DESIGN: This retrospective study enrolled uHCC patients treated with TTI or TACE alone between January 2018 and December 2023.
METHODS: The primary outcome was the time to progression of baseline ALBI grade, with secondary outcomes including overall survival (OS) and progression-free survival (PFS) of patients. Survival outcomes were analyzed using the Kaplan-Meier method.
RESULTS: A total of 162 patients (TTI group: 68; TACE alone group: 94) were included. The TTI group showed a significantly longer median time to progression of baseline ALBI grade than the TACE alone group (19.0 months vs 11.6 months, p = 0.004). Subgroup analyses revealed similar benefits of the TTI group (11.3 months vs 5.0 months for baseline ALBI grade 1, p = 0.015; 20.0 months vs 14.7 months for baseline ALBI grade 2, p = 0.025). Patients in the TTI group demonstrated superior median OS (42.2 months vs 22.0 months for baseline ALBI grade 1, p = 0.077; 22.6 months vs 13.5 months for baseline ALBI grade 2, p = 0.001) and longer median PFS (11.7 months vs 6.8 months for baseline ALBI grade 1, p = 0.148; 8.4 months vs 4.9 months for baseline ALBI grade 2, p = 0.022) compared to the TACE alone group.
CONCLUSION: TTI therapy preserved liver function for a longer duration and achieved better survival outcomes than TACE alone in uHCC patients, particularly benefiting those with baseline ALBI grade 2.