ABSTRACT
OBJECTIVES:
To explore the
efficacy and
safety of Transarterial chemoembolization (TACE) in combination with
immune checkpoint inhibitors (ICIs) and
tyrosine kinase inhibitors (TKIs) in
patients with unresectable
hepatocellular carcinoma (uHCC).
METHODS:
456
patients with HCC receiving either TACE in combination with ICIs and TKIs (combination group, n = 139) or TACE monotherapy (monotherapy group, n = 317) were included from Apr 2016 to Dec 2021 in this
retrospective study. We employed
propensity score matching (PSM), performed 12 optimal pair matching, to balance potential
bias.
RESULTS:
The mean follow-up
time is 24.7 months (95% CI 22.6-26.8) for matched
patients as of March 2022. After matching, the combination group achieved longer OS and PFS (median OS21.9 vs. 16.3 months, P = 0.022; median PFS 8.3 vs. 5.1 months, P < 0.0001) than TACE monotherapy group. The combination group had better objective response rate (ORR) and
disease control rate (DCR) (ORR 52.5% vs. 32.8%, P < 0.001; DCR 82.7% vs. 59.6%, P < 0.001). Subgroup
analysis showed that
patients who received "TKIs + ICIs" after the first TACE
procedure (after TACE group) achieved longer OS than those before the first TACE
procedure (before TACE group) (26.8 vs. 19.2 months, P = 0.011). Adverse events were consistent with previous studies of TACE-related trials.
CONCLUSIONS:
TACE plus TKIs and ICIs appeared to deliver longer PFS and OS in HCC
patients than TACE monotherapy. "TKIs + ICIs" co-
treatment within 3 months after the first TACE
procedure might be a better medication strategy.
