92P - TAE-HAIC plus lenvatinib and PD-1 inhibitors versus TAE-HAIC plus atezolizumab and bevacizumab for unresectable hepatocellular carcinoma: A propensity score matching study

Background

Systemic therapy combined with transarterial-based therapy has demonstrated promising results for unresectable HCC. Atezolizumab plus bevacizumab (“T+A”) is the standard first-line therapeutic regimen for advanced HCC, while lenvatinb combined programmed death-1 (PD-1) inhibitors shows synergistic anti-tumor effect as well. This study aims to compare the efficacy and safety of TAE-HAIC plus lenvatinib and PD-1 inhibitors versus TAE-HAIC plus “T+A” for unresectable HCC.

Methods

In this retrospective study, treatment-naïve unresectable HCC patients who were treated with TAE-HAIC plus lenvatinib and PD-1 inhibitors (THLP group) or TAE-HAIC plus “T+A” (THTA group) were included. The primary endpoint was overall survival (OS). The secondary outcomes included progression-free survival (PFS) and tumor response according to modified RECIST, and adverse events (AEs). We performed propensity score matching (PSM) approaches to reduce bias between two groups.

Results

From June 2020 to June 2023, 339 patients were enrolled in this study: 233 in the THLP group and 106 in the THTA group. After PSM with a ratio of 3:1, 153 and 51 patients were assigned to the THLP and THAT group, respectively. The THLP group showed a longer median OS (21.3 versus 18.2 months; P = 0.486), while median PFS was longer in the THTA group (6.8 versus 6.3 months; P = 0.552), both without statistical differences. There were no statistical differences in objective response rate (ORR) (73.3% versus 68.3%; P =0.635) and disease control rate (DCR) (91.7% versus 89.3%; P =0.716) neither. No significant difference in the rate of the grade 3/4 AEs was observed between the two groups, and all AEs were controllable. No treatment-related grade 5 AE took place in the two groups.

Conclusions

TAE-HAIC plus lenvatinib and PD-1 inhibitors or TAE-HAIC plus “T+A” demonstrated similar outcomes for unresectable HCC with acceptable toxic effects, which needs to be validated with larger-scale randomized clinical trials.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.