Clinical efficacy of HAIC (FOLFOX) combined with lenvatinib plus PD-1 inhibitors vs. TACE combined with lenvatinib plus PD-1 inhibitors in the treatment of advanced hepatocellular carcinoma with portal vein tumor thrombus and arterioportal fistulas

• Published in: American journal of cancer research 2023-01, Vol.13 (11), p.5455-5465
• Main Authors: Lin, Zhipeng, Chen, Du, Hu, Xiaolong, Huang, Dabei, Chen, Yuan, Zhang, Jian, Li, Xiaoqun, Zou, Xugong
• Format: Article
• Language: English
• Subjects: Original
• ISSN: 2156-6976; 2156-6976

This study aimed to evaluate the clinical efficacy of hepatic arterial infusion chemotherapy (HAIC) combined with lenvatinib and PD1 inhibitors vs. transarterial chemoembolization (TACE) combined with lenvatinib and PD1 inhibitors in the treatment of unresectable hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) and artery-portal shunts (APFs). HCC Patients with PVTT and APFs who received HAIC in combination with PD1 inhibitor or TACE in combination with lenvatinib and PD1 inhibitor from March 2019 to May 2023 in Zhongshan People's Hospital were included. The objective response rate (ORR), disease control rate (DCR), median overall survival (mOS), median progression-free survival (mPFS), median duration of response (mDOR), and adverse events (AEs) were assessed. A total of 95 patients were enrolled in this study, including 34 cases in the HAIC+L+P group and 61 cases in the TACE+L+P group. According to the RECIST1.1, the ORR was 52.9% and 27.9%, and the DCR was 100% and 88.5%, respectively ( values =0.03 and < 0.001, respectively). The mOS of HAIC+L+P group and TACE+L+P group were 25.00 and 19.30 months, respectively (P=0.035). The mPFS of the two groups were 21.74 and 8.74 months, respectively (P=0.0066). The mDOR of the two groups was 20.43 and 9.13 months, respectively (P=0.067). Compared with TACE in combination with lenvatinib and PD-1 inhibitors, HAIC (FOLFOX) in combination with lenvatinib and PD-1 inhibitors can improve tumor response and prolong OS, PFS, and DOR in HCC patients with PVTT and APFs.