Abstract 179P
Background
Combination of multiple therapies is a common approach to treating patients with advanced hepatocellular carcinoma (HCC). Transarterial chemoembolization (TACE) combined with lenvatinib and PD-L1/PD1 inhibitors may prolong the survival of patients with advanced HCC, but the actual effectiveness remains unclear. The purpose of this study was to compare the efficacy and safety of TACE combined with lenvatinib plus PD-L1/PD-1 inhibitor (TACE-L-P) with TACE combined with lenvatinib (TACE-L) in the treatment of patients with advanced HCC.
Methods
Publicly available studies comparing the efficacy of TACE-L-P and TACE-L in the treatment of advanced HCC were collected from PubMed, Embase and Cochrane Library with a cut-off date of February 2024. Stata SE 15 software was used for analysis.
Results
Thirteen studies involving 1227 patients were included, 605 in the TACE-L-P group and 622 in the TACE-L group. Meta-analysis showed that TACE-L-P was significantly more effective than TACE-L in complete response (RR = 2.07, 95% CI: 1.31, 3.27, P = 0.002), partial response (RR = 1.41, 95% CI: 1.15, 1.73, P = 0.001), disease control rate (RR = 1.20, 95% CI: 1.07, 1.35, P = 0.002), objective response rate (RR = 1.50, 95% CI: 1.22, 1.84, P < 0.0001), disease control rate (RR = 1.20, 95% CI: 1.07, 1.35, P = 0.002), overall survival (HR = 2.34, 95% CI: 1.52, 3.62, P < 0.05) and progression-free survival (HR = 2.09, 95% CI: 1.64, 2.67, P < 0.05). TACE-L-P was significantly less effective than TACE-L in progressive disease (RR = 0.48, 95% CI: 0.32, 0.71, P = 0.0002). No significant difference was found in stable disease (RR = 0.90, 95% CI: 0.74, 1.10, P = 0.31) as well as total and grade 3/4 adverse events between the two groups.
Conclusions
TACE-L-P significantly improved the survival of patients with advanced HCC with an acceptable range of adverse events compared to TACE-L. However, this conclusion still needs further confirmation in the future with more high-quality randomized controlled trials and longer follow-up.
Editorial acknowledgement
MogoEdit for its English editing during the preparation of this manuscript.
Legal entity responsible for the study
The authors.
Funding
Shenzhen High-Level Hospital Construction Fund, the Sanming Project of Medicine in Shenzhen (SZSM202011010).
Disclosure
All authors have declared no conflicts of interest.