Abstract 56P
Background
The optimal treatment strategy for advanced hepatocellular carcinoma (HCC) after lenvatinib failure remains unclear. This study aimed to compare the efficacy and safety of hepatic arterial infusion chemotherapy (HAIC) combined with either targeted therapy or immunotherapy combination in these patients.
Methods
We conducted a retrospective study of 49 patients with advanced HCC who experienced disease progression after lenvatinib treatment between February 2023 and February 2024. Patients were divided into two groups: HAIC plus lenvatinib (H+T group, n=18) and HAIC plus sintilimab and bevacizumab (H+I group, n=31). The primary endpoints were objective response rate (ORR) and progression-free survival (PFS). Secondary endpoints included disease control rate (DCR), overall survival (OS), and safety.
Results
The ORR was 22.2% in the H+T group versus 35.5% in the H+I group (p=0.534). The DCR was 88.9% versus 83.8% respectively (p=0.889). Median PFS was 10.1 months (95% CI: 8.3-11.9) in the H+T group versus 12.0 months (95% CI: 9.4-14.6) in the H+I group. Median OS was 15.9 months (95% CI: 11.5-20.3) versus 18.1 months (95% CI: 13.3-22.9) respectively. Both groups showed significant decreases in CEA, VEGF, and CA125 levels after treatment (p<0.05), with the H+I group showing more pronounced reductions. The incidence of adverse events was comparable between groups, with no significant differences in the safety profile.
Conclusions
HAIC combined with sintilimab and bevacizumab showed a trend toward improved ORR and survival outcomes compared to HAIC plus lenvatinib in advanced HCC patients after lenvatinib failure, with manageable safety profiles in both groups. These findings warrant further investigation in larger prospective studies.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.