977P - Transarterial chemoembolization combined with lenvatinib plus tislelizumab for unresectable hepatocellular carcinoma: A multicenter cohort study

Background

It remains to be further confirmed whether TACE combined with lenvatinib plus tislelizumab is superior to TACE combined with lenvatinib, particularly in determining which patients can benefit more from the triple combined therapy. Therefore, in this study, aiming to further validate the efficacy of TACE combined with lenvatinib plus tislelizumab, a multicenter cohort analysis were conducted for advanced HCC patients who received TACE combined with lenvatinib with or without tislelizumab.

Methods

From March 2021 to September 2023, a total of 169 patients from three centers were included in this study, with 103 patients receiving TACE combined with lenvatinib plus tislelizumab (TLT), and 66 patients receiving TACE combined with lenvatinib (TL). The Kaplan-Meier method was utilized to evaluate the cumulative overall survival (OS) and progression-free survival(PFS) between two groups and were assessed using the log-rank test. Subgroup analysis on tumor number, maximum tumor diameter, presence of portal vein thrombosis, AFP level and Child-Pugh class were conducted.

Results

The median follow-up time in this study was 23.0 months(95%CI:20.9-25.1). The median OS and PFS were longer in the TLT group than that in the TL group. The median OS in the TLT group was 26.0 months(95% CI: 22.5-29.5), while the median OS in the TL group was 22.0 months(95% CI: 17.0-25.0 months)(P=0.004). The median PFS was 14 months(95% CI:11.1-16.9) in the TLT group and 9 months(95% CI: 5.9-12.0 months) in the TL group (P=0.044). Subgroup analysis showed that for patients with a maximum tumor diameter greater than 7cm, AFP >400ng/ml and accompanied by portal vein tumor thrombus and Child-Pugh class A, there was a statistically significant difference in OS between TLT and TL groups. In the TLT group, 20.1% experienced grade 3-4 adverse events (AEs), while in the TL group, 14.7% reported grade 3-4 AEs.

Conclusions

OS and PFS were significantly improved in patients who received TLT compared to those who received TL, patients with a maximum tumor diameter greater than 7cm, AFP >400ng/ml, Child-Pugh class A and PVTT appeared to derive more benefit.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Shanxi Natural Science Research General Project (202303021211201).

Disclosure

All authors have declared no conflicts of interest.