Purpose Advanced hepatocellular carcinoma (HCC) remains a challenge for clinical treatment. The purpose of this study is to compare the efficacy of a quadruple combination of hepatic arterial infusion chemotherapy (HAIC) with transhepatic arterial embolization (TAE), lenvatinib, and tislelizumab (THLP group) with that of a triple combination of transarterial chemoembolization (TACE) with lenvatinib and tislelizumab (TLP group) in advanced HCC. Methods In this retrospective study, we analyzed clinical information on patients diagnosed with advanced HCC with different treatments between October 2020 and December 2022 at Wuming Hospital. Primary outcomes included overall survival (OS), and progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR). Results The study included 116 patients, 69 in the TLP group and 47 in the THLP group. Median OS and PFS for the entire cohort were 13 (95% CI, 12.0-14.0) and 9.0 (95% CI, 7.7-10.2) months. OS (median, 17 vs. 12 months, P 0.001) and PFS (median, 11 vs. 7 months, P 0.001) were significantly prolonged in the THLP group compared with the TLP group. After correcting for confounders using 1:1 PSM, the results remained robust. The ORR and DCR were significantly higher in the THLP group than in the TLP group according to mRECIST (ORR: 74.5 vs. 52.2%, P = 0.015; DCR: 87.3% vs. 71.0%, P = 0.040). There were no grade 4 or higher adverse events. Conclusion The quadruple combination of HAIC, TAE, lenvatinib, and tislelizumab in the treatment of advanced HCC has a better prognosis than the triple combination of TACE in combination with lenvatinib and tislelizumab, with tolerant safety.
Yaqiong Wang (Tue,) studied this question.
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