Journal of Hepatocellular Carcinoma (Jul 2023)

Transarterial Chemoembolization Combined with Atezolizumab Plus Bevacizumab or Lenvatinib for Unresectable Hepatocellular Carcinoma: A Propensity Score Matched Study

  • Zhao C,
  • Xiang Z,
  • Li M,
  • Wang H,
  • Liu H,
  • Yan H,
  • Huang M

Journal volume & issue
Vol. Volume 10
pp. 1195 – 1206

Abstract

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Chenghao Zhao,* Zhanwang Xiang,* Mingan Li, Haofan Wang, Huan Liu, Huzheng Yan, Mingsheng Huang Department of Interventional Radiology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, People’s Republic of China*These authors contributed equally to this workCorrespondence: Mingsheng Huang; Huzheng Yan, Tel/Fax +86-20-85253416, Email [email protected]; [email protected]: Combined transarterial chemoembolization (TACE) and Lenvatinib (LEN) treatment (LEN-TACE) has been shown to be beneficial. We aimed to evaluate retrospectively Atezolizumab plus Bevacizumab (Atezo/Bev)-TACE compared with LEN-TACE as a first-line therapy for unresectable HCC.Patients and Methods: From October 2020 to October 2022, data from 98 consecutive HCC patients were analyzed. After propensity score matching, two cohorts of 34 patients who received either Atezo/Bev-TACE or LEN-TACE were studied. We compared overall survival (OS), progression-free survival (PFS), duration of response, objective response rate (ORR) and disease control rate (DCR) based on RECIST 1.1 and mRECIST, as well as safety outcome between the two cohorts.Results: The 6-month and 12-month OS rates were 85.3% (95% CI 73.5– 97.0) and 75.4% (95% CI 53.6– 85.7) in the Atezo/Bev-TACE group, and 88.2% (95% CI 76.5– 97.1) and 79.2% (95% CI 63.6– 90.9) in the LEN-TACE group, respectively. The hazard ratio for death in the Atezo/Bev-TACE group compared to the LEN-TACE group was 1.09 (95% CI 0.47– 2.51; P = 0.837). The median PFS was 7.03 months (95% CI 3.89– 10.17) in the Atezo/Bev-TACE group and 6.03 months (95% CI 0– 14.14) in the LEN-TACE group (HR 1.21; 95% CI 0.66– 2.21; P = 0.545). No significant difference in ORR and DCR between the two groups was observed either according to RECIST 1.1 or mRECIST standards. Incidence rates of hand-foot skin reaction (35.3% vs 5.9%, P = 0.003) and proteinuria (17.9% vs 2.9%, P = 0.046) were significantly higher in the LEN-TACE group.Conclusion: Atezo/Bev-TACE and LEN-TACE showed comparable efficacy and safety as first-line therapies for unresectable HCC patients.Keywords: atezolizumab plus bevacizumab, lenvatinib, transarterial chemoembolization, hepatocellular carcinoma, efficacy

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