Efficacy and survival analysis of sintilimab combined with lenvatinib and transarterial chemoembolization in treatment of patients with primary liver cancer
Zhang Hui-ling
Zhang Hong-wei
Chen Kuang-rong
Li Dong
Yang Lin
Abstract：Objective To investigate the efficacy and survival rate of sintilimab combined with lenvatinib and transarterial chemoembolization(TACE)in the treatment of primary liver cancer(PLC).Methods A prospective randomized controlled study was conducted.A total of 80 patients with PLC treated in Ziyang Central Hospital from January 2021 to October 2022 were selected,and divided into two groups using the envelope method,with 40 in each group.The patients in the control group were treated with lenvatinib and TACE and those in the experimental group with sintilimab on the basis of the treatment regimen in the control.One month after the first TACE,the two groups were compared in terms of liver function,the levels of tumor markers and tumor angio-genesis factors,adverse reactions,and clinical efficacy.All patients were followed up for 2 years.Overall survival rates and progres-sion-free survival time of the two groups were also compared.Results After treatment,the levels of alanine aminotransferase,aspartate aminotransferase,total bilirubin,alpha fetoprotein,carcinoembryonic antigen,carbohydrate antigen 199,vascular endothe-lial growth factor and basic fibroblast growth factor in the experimental group were lower than those in the control group((44.36±5.27)U·L-1 vs(47.16±5.38)U·L-1,(49.06±4.28)U·L-1 vs(51.87±5.64)U·L-1,(24.18±3.65)μmol·L-1 vs(26.39±3.47)μmol·L-1,(103.84±16.7)ng·mL-1 vs(115.06±19.34)ng·mL-1,(17.68±4.35)ng·mL-1 vs(20.13±4.29)ng·mL-1,(178.46±23.5)U·mL-1 vs(195.37±28.63)U·mL-1,(179.53±8.62)pg·mL-1 vs(186.49±10.13)pg·mL-1,(6.53±1.27)pg·mL-1 vs(8.14±1.95)pg·mL-1)(t=2.351,2.510,2.775,2.776,2.536,2.887,3.309,4.376,all P<0.05).There were no statistical differences in the incidence rates of fever,hyperten-sion,gastrointestinal reactions and leukopenia between the experimental group and the control group(5.00%vs 7.50%,22.50%vs 17.50%,15.00%vs 12.50%,12.50%vs 10.00%)(χ2=0.213,0.312,0.105,0.125,all P>0.05).The objective response rate(ORR)and disease control rate(DCR)in the experimental group were higher than those in the control group(52.50%vs 27.50%,87.50%vs 65.00%)(χ2=5.208,5.591,both P<0.05).The 2-year survival rate in the experimental group was higher than that in the control group,but the difference was not statistically significant(72.50%(29/40)vs 57.50%(23/40),Log-rank χ2=1.978,P=0.160).Median PFS of the experi-mental group and the control group was 11.2 months and 5.8 months,respectively.The difference was statistically significant(Log-rank χ2=6.204,P=0.013).Conclusion Sintilimab combined with lenvatinib and TACE is effective in the treatment of PLC since it can sig-nificantly improve liver function,reduce tumor marker levels,inhibit tumor growth and extend the progression-free survival time.
Keywords：SintilimabLenvatinibTransarterial chemoembolizationPrimary liver cancerClinical efficacySurvival rate
Publication Date：2025-04-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 234-238 )