Purpose: This study was designed to compare the safety and efficacy of transarterial chemoembolization (TACE) plus hepatic arterial infusion chemotherapy (HAIC) or TACE combined with lenvatinib (LEN) and PD-1 inhibitors (PD-1i) in large intermediate-stage hepatocellular carcinoma (iHCC). Methods: This multi-center retrospective study was conducted at four tertiary medical centers. From January 01, 2021, to June 30, 2024, 221 patients with large iHCC undergoing TACE-HAIC-LEN-PD-1i (THLP group, n=103) or TACE-LEN-PD-1i (TLP group, n=118) were enrolled. Local tumor responses, survival, and treatment-related adverse events (TRAEs) were analyzed between the THLP and TLP groups. Results: Baseline characteristics were well-balanced between the two groups ( P > 0.05). Objective response rate (70.8% vs. 44.9%, P 0.05). No grade 5 TRAEs and treatment-related mortality were observed. Conclusion: TACE-HAIC-LEN-PD-1i was safe and well-tolerated, and achieved better efficacy than TACE-LEN-PD-1i in patients with large iHCC. Further randomized controlled trials are required to validate the benefits of TACE-HAIC-LEN-PD-1i. Keywords: hepatocellular carcinoma, transarterial chemoembolization, hepatic arterial infusion chemotherapy, tyrosine kinase inhibitor, immune checkpoint inhibitor
Ni et al. (Wed,) studied this question.