Abstract 996P
Background
For unresectable hepatocellular carcinoma (uHCC), the efficacy of transarterial chemoembolization (TACE) monotherapy is not satisfactory. Some studies have shown that TACE combined with molecular targeted drugs and programmed death-1 (PD-1) inhibitors shows potential synergistic effects that can prolong the overall survival (OS) of patients with uHCC. Donafenib is a new generation of multi-kinase inhibitor which is approved as the first line treatment for uHCC. This study aimed to evaluate the efficacy and safety of TACE combined with donafenib plus PD-1 inhibitor (TACE+DP) and of TACE combined with donafenib (TACE+D) for uHCC in a multicenter retrospective study.
Methods
The clinical data of patients with uHCC who had received TACE+DP or TACE+D as first-line treatment from six Chinese academic centers, from July 2021 to July 2022, were collected and retrospectively analyzed. In the TACE+DP group, patients received intravenous administration of PD-1 inhibitor every three weeks and oral donafenib (0.2 g) twice daily until intolerable toxicity or disease progression. In the TACE+D group, patients received the same dose of donafenib 3-5 days after TACE. Overall survival (OS), progression-free survival (PFS), and tumor responses were evaluated between the two groups according to the modified RECIST criteria.
Results
A total of 157 patients in the TACE+D group and 166 patients in TACE+DP group were included in this study. Patients in the TACE+DP group had longer median OS (18.1 vs 13.2 months, P<0.001) and longer median PFS (10.6 vs 7.9 months, P<0.001) than those in the TACE+D group. Patients in the TACE+DP group achieved a higher ORR (50.6% vs 41.4%, P=0.019) and a higher disease control rate (DCR) (89.2% vs 82.8%, P=0.010) than those in the TACE+D group. There was no significant difference in the incidence and severity of adverse events in the TACE+DP and TACE+D groups (any grade, 92.9% vs. 94.6%, P=0.270; grade 3 or 4, 33.8% vs. 37.3%, P=0.253).
Conclusions
With favorable safety and tolerability, TACE combined donafenib with PD-1 inhibitors significantly improves PFS, OS, and ORR over TACE combined with donafenib.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The First Affiliated Hospital of Zhengzhou University.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
967P - The effect of prognosis value of EZH2 (Enhancer Of Zeste Homologue) staining in hepatocellular cancer
Presenter: Mehmet Kidi
Session: Poster session 18
968P - High sensitivity routine blood based detection of HCC: An AI model from 220k patients
Presenter: Kin Nam Kwok
Session: Poster session 18
969P - Establishing a novel routine blood component signature for Hepatocellular Carcinoma (HCC) screening with big clinical data
Presenter: Ka Man Cheung
Session: Poster session 18
970P - Real-world multi-center study of systemic treatment after first-line atezolizumab plus bevacizumab for advanced hepatocellular carcinoma in Asia-Pacific countries
Presenter: Choong-kun Lee
Session: Poster session 18
971P - Effect of preoperative frailty on surgical outcomes following hepatic resection for elderly patients with hepatocellular carcinoma: A multicenter retrospective cohort study from China
Presenter: Zhongqi Fan
Session: Poster session 18
972P - Sequential therapies after atezolizumab plus bevacizumab or lenvatinib first-line treatments in advanced hepatocellular carcinoma
Presenter: Mara Persano
Session: Poster session 18
973P - Clinicopathologic and treatment outcome data in 165 fibrolamellar carcinoma patients
Presenter: Sunyoung Lee
Session: Poster session 18
974P - The barthel index predicts surgical textbook outcomes following hepatectomy for elderly patients with hepatocellular carcinoma: A multicenter cohort study from China
Presenter: Guoyue Lv
Session: Poster session 18
975P - The clinical impact of urinary protein creatinine ratio and AFP at six weeks in patients with unresectable hepatocellular carcinoma treated with atezolizumab plus bevacizumab
Presenter: Kaoru Tsuchiya
Session: Poster session 18
976P - Overall survival in advanced hepatocellular carcinoma treated with concomitant systemic therapy and stereotactic radiation therapy or systemic therapy alone
Presenter: Alexander Piening
Session: Poster session 18