Abstract Objective To investigate the efficacy and safety of transarterial chemoembolization (TACE) combined with lenvatinib and icaritin in the treatment of patients with unresectable hepatocellular carcinoma (uHCC) with poor physical condition, aiming to provide a safer and more effective treatment strategy for patients with advanced uHCC and poor physical status. Materials and methods Clinical data from 49 patients with uHCC and poor physical condition who received treatment between June 2022 and December 2023 were collected. The patients were divided into two groups based on their treatment method: TACE + LEN+Icaritin group ( N = 21) and TACE group ( N = 28). The primary endpoints were the objective response rate (ORR), disease control rate (DCR), and progression-free survival (PFS) of the tumor in both groups. The secondary endpoint was the incidence of treatment-related adverse events (AEs) in both groups. Results The ORR and DCR of the TACE + LEN+Icaritin group were significantly higher than those of the TACE group (66.7% vs. 28.6%, P = 0.011; 85.7% vs. 53.6%, P = 0.030). The mPFS of the TACE + LEN+Icaritin group was longer than that of the TACE group (8.6 months vs. 4.1 months, HR = 0.316, 95%CI: 0.166–0.599; P < 0.001). The incidence of hand-foot syndrome (all grades) was higher in the TACE + LEN+Icaritin group compared to the TACE group ( P = 0.004), but there was no significant difference in the incidence of grade 3/4 hand-foot syndrome between the two groups ( P = 0.429). The incidence of fatigue and anorexia (all grades) was lower in the TACE + LEN+Icaritin group compared to the TACE group ( P < 0.05). A total of 66.7% of patients in the TACE + LEN+Icaritin group showed improvement in physical condition after treatment, which was significantly higher than in the TACE group ( P = 0.022). Conclusion TACE combined with lenvatinib and icaritin demonstrates good efficacy and safety in the treatment of patients with uHCC and poor physical condition (ECOG = 2). This combination therapy may be a viable option for improving prognosis and quality of life in patients with uHCC and poor physical condition.
Lu et al. (Mon,) studied this question.