Enhanced antitumor activity of combined hepatic arterial infusion chemotherapy with Lenvatinib and PD-1 inhibitors in unresectable hepatocellular carcinoma: a meta-analysis

Frontiers in Oncology, Journal Year: 2025, Volume and Issue: 15

Published: Feb. 12, 2025

Background Hepatic arterial infusion chemotherapy (HAIC) is increasingly recognized as a primary treatment option for patients with unresectable hepatocellular carcinoma (uHCC), providing focused localized tumors. The combination of lenvatinib, multikinase inhibitor, PD-1 inhibitors has demonstrated significant survival benefits in HCC. This meta-analysis aims to assess whether the integration HAIC lenvatinib and (referred HAIC-L-P group) leads better effectiveness security compared alone (L-P uHCC. Methods An exhaustive search literature was conducted, including PubMed, Cochrane Library, Embase, ClinicalTrials.gov, Web Science, from start each database until September 2024, ensure thorough up-to-date compilation relevant studies. Extract data on outcome measures such overall (OS), progression-free (PFS), objective response rate (ORR), disease control (DCR), adverse events (AEs). Subsequently, meta-analyses were performed using RevMan 5.4 quantitatively evaluate aggregated effect regimen versus L-P alone. Results In our systematic eight retrospective cohort studies, markedly enhanced OS, an HR 0.54 (95% CI: 0.45-0.64; p < 0.00001), 1-year 2-year OS rates. Superior PFS also observed group, 0.64 0.55-0.75; 0.0001), higher Response rates ORR risk ratio 2.15 1.84-2.50; 0.00001) DCR 1.28 1.20-1.43; 0.0001). AEs classified grade 3 or above elevated notable ratios vomiting, AST, ALT, thrombocytopenia, neutropenia, hyperbilirubinemia. No life-threatening reported. Conclusion correlated tumor responses prolonged survival, alongside manageable effects, indicating its potential viable therapeutic strategy individuals afflicted Systematic review registration https://www.crd.york.ac.uk/PROSPERO/ , identifier CRD42024594109.

Language: Английский

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Adverse events associated with hepatic arterial infusion chemotherapy and its combination therapies in hepatocellular carcinoma: a systematic review

Frontiers in Immunology, Journal Year: 2025, Volume and Issue: 16

Published: March 3, 2025

Background Hepatic arterial infusion chemotherapy (HAIC) has emerged as a promising treatment for unresectable hepatocellular carcinoma (HCC). However, the safety profiles of HAIC and its various combination therapies remain to be systematically evaluated. Methods We searched PubMed, Embase, Cochrane Library, Web Science databases from inception November 2024. Studies reporting adverse events (AEs) monotherapy or in HCC were included. The severity frequency AEs analyzed according different protocols. Results A total 58 studies (11 prospective, 47 retrospective) demonstrated relatively mild toxicity, primarily affecting hepatobiliary (transaminase elevation 53.2%, hypoalbuminemia 57.2%) hematological systems (anemia 43.0%, thrombocytopenia 35.2%). with targeted therapy showed increased events, including characteristic reactions like hand-foot syndrome (48.0%) hypertension (49.9%). combined targeted, immunotherapy exhibited highest reaction rates (neutropenia 82.9%, transaminase 97.1%), while anti-angiogenic favorable profile. Prospective consistently reported higher incidence than retrospective studies, suggesting potential underreporting clinical practice. Conclusions Different HAIC-based regimens exhibit distinct requiring individualized management approaches. propose comprehensive framework patient selection, monitoring strategies, AE management. These recommendations aim optimize outcomes minimizing impacts on quality life.

Language: Английский

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Predictive factors and prognostic models for Hepatic arterial infusion chemotherapy in Hepatocellular carcinoma: a comprehensive review

World Journal of Surgical Oncology, Journal Year: 2025, Volume and Issue: 23(1)

Published: April 26, 2025

Hepatocellular carcinoma (HCC) is a prevalent and lethal cancer, often diagnosed at advanced stages where traditional treatments such as surgical resection, liver transplantation, locoregional therapies provide limited benefits. Hepatic arterial infusion chemotherapy (HAIC) has emerged promising treatment modality for HCC, enhancing anti-tumor efficacy through targeted drug delivery while minimizing systemic side effects. However, the heterogeneous nature of HCC leads to variable responses HAIC, highlighting necessity reliable predictive indicators tailor personalized strategies. This review explores factors influencing HAIC success, including patient demographics, tumor characteristics, biomarkers, genomic profiles, imaging techniques radiomics deep learning models. Additionally, synergistic potential combined with immunotherapy molecular examined, demonstrating improved survival outcomes. Prognostic scoring systems nomograms that integrate clinical, molecular, data are discussed superior tools individualized prognostication compared staging systems. Understanding these predictors essential optimizing quality life patients HCC. Future research directions include large-scale prospective studies, integration multi-omics data, advancements in artificial intelligence refine models further personalize approaches.

Language: Английский

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TACE Combined with Portal Vein Tumor Thrombus 125I Seed Implantation in the Treatment of HCC with Hepatic Arterioportal Shunts

Journal of Hepatocellular Carcinoma, Journal Year: 2024, Volume and Issue: Volume 11, P. 1689 - 1697

Published: Sept. 1, 2024

Background and Objectives: Transarterial chemoembolization (TACE) 125 I seed implantation are methods used to treat hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT), PVTT often associated arterioportal shunts(APS), there few reports on the combined use of TACE for such patients. This study aimed evaluate efficacy safety in treatment HCC patients APS. Methods: Forty-two diagnosed APS between January 2020 December 2021 were included. Appropriate materials selected transarterial embolization APS, seeds implanted into PVTT. The occlusion effect was observed recorded after 3 months, intrahepatic lesions evaluated, patient survival, prognostic factors affecting recanalization analyzed. Results: All 42 completed follow-up three months treatment. immediate improvement rate 100%, at three-month 64.29%. disease control rates 81.00% 78.60%, respectively. patients' 6-month 12-month survival 78.6% 46.8%. median OS all 11.90 13.30 effective group 8.30 ineffective group. type is only independent factor recanalization. ( P =0.02). Conclusion: For combine a potentially safe method that contributes prolonging survival. Keywords: carcinoma, chemoembolization, thrombus, seed, shunts

Language: Английский

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