Abstract 155P
Background
Hepatocellular carcinoma (HCC) patients with portal vein tumour thrombus (PVTT) or extrahepatic spread have a poor prognosis, with very few treatment options and a median survival time of fewer than 4 months without treatment. These BCLC-stage C patients are usually treated with systemic chemotherapy alone, mainly because of the sparsely available transarterial chemoembolization (TACE). Also, these patients present with deranged liver function or a higher ECOG score, which makes TACE unfeasible. The current guidelines recommend Lenvatinib for BCLC-stage C patients. Currently, there is insufficient evidence on the efficacy and survival benefits of TACE combined with Lenvatinib in BCLC-stage C patients. So, this study aimed to check the efficacy and impact of TACE combined with Lenvatinib on the overall survival (OS) of patients suffering from HCC belonging to BCLC- stage C with maintained liver function.
Methods
This study was a prospective observational study conducted for 24 months. The inclusion criteria were HCC presenting with PVTT, extrahepatic metastasis, and Child-Pugh A to B7. The patient underwent CECT for tumour evaluation, after which TACE was performed, followed by Lenvatinib. Then, patients underwent an MRI after 4 weeks of TACE to assess their treatment response. The second or third session of the TACE was performed if there was a residual disease. The patients were followed every 3 months intervals.
Results
After a median follow-up of 24 months for a total of 26 patients, 20 patients survived, and 6 patients died. Among 26 patients of BCLC stage C, 38.5% had PVTT, 7.6% had both portal vein and hepatic vein invasion, 23.1% had lung metastasis, and 30.8% had metastatic retroperitoneal lymphadenopathy. All these patients 9-month and 12-month survival rates were 80.8% and 76.9%. The median OS of all included patients was 17.5 months. Of 26 patients, 57.7% showed partial response, 30.8% showed stable disease, and 11.5% showed progressive disease.
Conclusions
Patients with BCLC stage C treated with TACE combined with lenvatinib had significant survival benefits and significantly prolonged the overall survival time of these patients with a good safety profile.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.