981P - Tyrosine kinase inhibitors vs anti-VEGF antibody, combined with anti-PD-1 inhibitors and TACE in the conversion therapy for hepatocellular carcinoma: A retrospective multicenter real-world study

Background

Both tyrosine kinase inhibitors (TKIs, i.g., lenvatinib and donafenib) and anti-VEGF antibody (bevacizumab) are widely used anti-angiogenesis regimens but have different pharmacokinetics and toxicity. We aimed to compare the efficacy and safety between TKIs-based triple therapy (TkiTT) and bevacizumab-based triple therapy (BevTT) during the perioperative period in patients who underwent curative surgical resection after successful conversion for initially unresectable hepatocellular carcinoma (HCC).

Methods

272 consecutive patients who were initially diagnosed as unresectable HCC and received Lenvatinib/donafenib or bevacizumab combined with anti-PD-1 antibody and transarterial chemoembolization (TACE) between January 2022 and December 2023 from three tertiary-care hospitals were screened, and those underwent radical surgical resection after successful tumor downstaging were finally included. Clinical, imaging and pathological parameters during the perioperative period were compared between TkiTT group and BevTT group.

Results

A total of 106 HCC patients successfully received radical resection after conversion. The conversion rate was 41.8% (46/110) and 37% (60/162) in TkiTT group and BevTT group, respectively (p =0.427). The patient characteristics, tumor features and conversion time did not differ significantly between the two groups (Table). BevTT group had a significantly longer drug withdrawal time than TkiTT group. The operation time, intra-operative bleeding, and post-operative liver function recovery did not differ significantly between the two groups. No major complication occurred in the two groups. The pathology showed significantly higher complete response rate in TkiTT group than that in BevTT group. Table: 981P