A retrospective controlled study of TACE combined with targeted therapy and immunotherapy for intermediate hepa-tocellular carcinoma

HU Di; HUANG Jintao; SHEN Jian; ZHONG Binyan; LI Wanci; ZHANG Shuai; ZHU Xiaoli

Abstract：Objective To evaluate the efficacy of transarterial chemoembolization(TACE)combined with tyrosine kinase in-hibitors(TKIs)and immune checkpoint inhibitors(ICIs)in the treatment of intermediate hepatocellular carcinoma(HCC)com-pared to TACE alone.Methods The clinical data of 79 patients with intermediate HCC admitted to our hospital were selected.Those patients were divided into a combination group(TACE combined with targeted therapy and immunotherapy)of 27 cases and a control group(TACE alone)of 52 cases according to different treatment plans.A 1:1 propensity score matching(PSM)was performed on the combination group and the control group.The main outcome was overall survival(OS),while the secondary outcomes were progression free survival(PFS),objective response rate(ORR),disease control rate(DCR),and adverse events(AEs).Results After using propensity score matching,there were 27 cases in the combination group and 27 cases in the control group,and the baseline data between the paired groups were comparable.During the median follow-up time of 23 months,compared with the control group,the OS(33.7 vs 13.0 months)and PFS(9.9 vs 7.9 months)of patients in the combina-tion group were significantly prolonged,while ORR(59.3%vs 29.6%)and DCR(88.9%vs 63.0%)were also significantly in-creased.The above differences were statistically significant(P<0.05).There was no statistically significant difference in the inci-dence of adverse reactions such as fever,abdominal pain,and nausea and vomiting between the two groups(P>0.05).The inci-dence of grade 3 and above adverse reactions(including hand foot syndrome and proteinuria)in the combination group was rela-tively low,while there were no grade 3 or above adverse reactions in the control group.All adverse reactions could be alleviated after symptomatic treatment.Conclusion Compared with TACE alone,for patients with intermediate HCC,TACE combined with targeted therapy and immunotherapy can significantly prolong the patient's OS,PFS,improve ORR and DCR,and have controllable adverse reactions.