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September 4, 2026Journal of Hepatocellular CarcinomaOpen Access

Nivolumab Plus Lenvatinib and Intra-Arterial Locoregional Therapy as First-Line Treatment for Unresectable Hepatocellular Carcinoma: A Real-World Study

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Authors

SGShanzhi GuYZYang ZhaoHYHaixiong Yan

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Overview

Retrospective study demonstrates high response rates and prolonged survival with triple therapy in unresectable hepatocellular carcinoma, suggesting strong potential as first-line treatment.

Key Points

  • To assess the efficacy and safety of first-line triple therapy combining nivolumab, lenvatinib, and intra-arterial locoregional therapy in patients with unresectable hepatocellular carcinoma.
  • Retrospective study of 52 treatment-naive patients with unresectable hepatocellular carcinoma treated between March 2020 and October 2023 (median age < 65 years: 86.5%, male: 90.4%, Child–Pugh class A: 92.3%).
  • Patients received nivolumab plus lenvatinib alongside intra-arterial locoregional therapy, consisting of transarterial chemoembolization or hepatic arterial infusion chemotherapy.
  • Evaluated endpoints included objective response rate (ORR), disease control rate (DCR), duration of response, progression-free survival (PFS), overall survival (OS), and safety over a median follow-up of 22.0 months.
  • The ORR was 69.2% (95% CI: 54.9%–81.3%) by mRECIST and 55.8% (95% CI: 41.3%–69.5%) by RECIST v1.1, with a 100% DCR achieved under both assessment criteria.
  • Median PFS was 16.8 months (95% CI: 12.9–20.5) by mRECIST and 16.6 months (95% CI: 12.8–20.2) by RECIST v1.1, while median OS reached 24.9 months (95% CI: 21.7–35.6).
  • Treatment-emergent adverse events occurred in 86.5% of patients (most commonly fatigue at 30.8%), with grade ≥ 3 adverse events observed in 17.3%.

Cite This Study

Gu et al. (2026) studied this question.

synapsesocial.com/papers/6a9a85b05d9e33f25c6310fahttps://doi.org/10.2147/jhc.s625046
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Systemic Lenvatinib Therapy Combined with Locoregional Chemoembolisation and Hepatic Arterial Infusion Chemotherapy for Advanced Hepatocellular Carcinoma with Main Portal Vein Invasion: A Multicentre Retrospective Case—Control Study2026
  2. 2Adebrelimab plus interventional and targeted therapy for unresectable hepatocellular carcinoma: A single-arm, real-world study.2026
  3. 3Lenvatinib combined with immune checkpoint inhibitors for unresectable, recurrent, or metastatic hepatocellular carcinoma: A real-world study2026
  4. 4Efficacy and safety of hepatic arterial infusion chemotherapy combined with lenvatinib and PD-1 inhibitors for advanced hepatocellular carcinoma with macrovascular invasion2024 · 10 citations
  5. 5A Real‐World Experience of Prognostic Factors of Survival Outcomes in a Taiwanese Population With Unresectable Hepatocellular Carcinoma Treated With First‐Line Lenvatinib2026